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目的对比研究常规MRI、定量MRI和磁共振波谱成像(magnetic resonance spectroscopy,MRS)对海马硬化(hippocampal sclerosis,HS)的定侧诊断价值。方法30例HS患者术前行常规MRI、定量MRI和MRS检查,并进行定侧诊断,其结果与手术结果对照。结果30例中常规MRI显示海马形态和/或信号异常23例,其中能定侧诊断18例,与手术结果对照定侧正确17例;定量MRI诊断海马单侧或双侧萎缩25例,能定侧诊断23例,与手术结果对照定侧正确21例;MRS显示单侧或双侧NAA/(Cho+Cr)值减低28例,能定侧诊断27例,与手术结果对照定侧正确26例。常规MRI、定量MRI和MRS对HS的定侧诊断敏感性和特异性分别为56.67%(17/30)及94.44%(17/18),70.00%(21/30)及91.30%(21/23),86.67%(26/30)及96.30%(26/27)。结论常规MRI、定量MRI和MRS对HS定侧诊断敏感性有显著差异,即MRS>定量MRI>常规MRI扫描(P<0.05);3种方法对HS定侧诊断特异性均很高且无显著差异(P>0.05)。
Objective To compare the diagnostic value of routine MRI, quantitative MRI and magnetic resonance spectroscopy (MRS) in hippocampal sclerosis (HS). Methods Thirty patients with HS underwent preoperative routine MRI, quantitative MRI and MRS examinations, and diagnosed side by side. The results were compared with the surgical results. Results Of the 30 cases, routine MRI showed 23 cases of hippocampal morphology and / or signal abnormalities, of which 18 cases were diagnosed side-by-side and 17 cases were correctly matched with surgical results. Quantitative MRI diagnosed 25 cases of unilateral or bilateral atrophy of hippocampus, MRS showed that the unilateral or bilateral NAA / (Cho + Cr) values were reduced in 28 cases and 27 cases were diagnosed side-by-side, and 26 cases were correctly diagnosed according to the surgical results . The diagnostic sensitivity and specificity of conventional MRI, quantitative MRI and MRS for HS were 56.67% (17/30) and 94.44% (17/18), 70.00% (21/30) and 91.30% (21/23) respectively ), 86.67% (26/30) and 96.30% (26/27) respectively. Conclusion The sensitivity of routine MRI, quantitative MRI and MRS in diagnosing HS is significantly different, ie MRS> quantitative MRI> conventional MRI (P <0.05). The specificity of three methods in diagnosing HS is high and no significant Difference (P> 0.05).