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本研究通过分析磁共振弥散张量成像(diffusion tensor imaging,DTI)数据,观察内侧颞叶癫痫(mesial temporal lobe epilepsy,mTLE)患者大脑白质的改变。46例伴有单侧海马硬化的内侧颞叶癫痫患者(24例左侧颞叶癫痫和22例右侧颞叶癫痫),以及42例年龄和性别匹配的正常志愿者纳入本研究。采用基于纤维束追踪的空间统计分析方法(track-based spatialstatistics,TBSS),主要观察患者各向异性系数(fractionsal anisotropy,FA)的变化。结果发现,与正常志愿者相比,左侧mTLE患者FA降低的区域呈双侧分布,稍偏向患侧,胼胝体、上纵束、下纵束、内囊前肢等白质双侧都有异常,而扣带束、下额枕束只在左脑显著降低;右侧mTLE患者FA降低主要见于右脑,包括胼胝体、上纵束、下纵束和钩束等。结果表明,基于TBSS方法的DTI研究揭示了伴有海马硬化的mTLE患者的脑白质异常,有助于加深对mTLE病理生理机制的了解。
In this study, white matter changes in patients with medial temporal lobe epilepsy (mTLE) were observed by analyzing magnetic resonance diffusion tensor imaging (DTI) data. 46 patients with unilateral hippocampal sclerosis medial temporal lobe epilepsy (24 cases of left temporal lobe epilepsy and 22 cases of right temporal lobe epilepsy), and 42 age and gender matched normal volunteers were included in the study. The track-based spatial statistics (TBSS) was used to observe the change of anisotropy coefficient (FA) of the patients. The results showed that, compared with the normal volunteers, left FA mTLE patients with decreased bilateral distribution of the area, slightly biased to the affected side, the corpus callosum, the longitudinal, lower longitudinal bundle, the white matter of the prefrontal internal capsule and other white matter both have abnormalities, and The cingulate bundles and suboccipital cusps only decreased significantly in the left brain. The decrease of FA in the right mTLE patients was mainly seen in the right brain, including the corpus callosum, the upper longitudinal, the lower longitudinal and the hook bundle. The results showed that the DTI study based on the TBSS method revealed abnormalities of white matter in mTLE patients with hippocampal sclerosis and could help to deepen the understanding of the pathophysiological mechanism of mTLE.