Hugg J W, Laxer K D, Matson G B, Maudsley A A, Husted C A, Weiner M W
MR Unit, Department of Veterans Affairs Medical Center, San Francisco, CA.
Neurology. 1992 Oct;42(10):2011-8. doi: 10.1212/wnl.42.10.2011.
We attempted to lateralize the epileptogenic focus (seven temporal lobe hippocampal foci, one frontal lobe focus) in medically refractory unilateral complex partial seizures, using noninvasive 31P magnetic resonance spectroscopic imaging (MRSI) blindly and interictally to compare hippocampal or frontal regions. The seizure foci were more alkaline (intracellular pH = 7.17 +/- 0.03) compared with the contralateral region (7.06 +/- 0.02, p < 0.01) in all eight cases; the inorganic phosphate was relatively increased (240 +/- 50% of contralateral, seven of eight cases, p < 0.01); and phosphomonoesters were relatively reduced (68 +/- 9% of contralateral, seven of eight cases, p < 0.01). Other phosphorus metabolites were symmetric (+/- 10%). 31P MRSI correctly lateralized the seizure focus in all eight cases. By comparison, imaging correctly lateralized four cases and SPECT, two cases. In conclusion, 31P MRSI is a useful tool for the noninvasive clinical assessment of focal epilepsy and can accurately lateralize the epileptogenic focus.
我们试图在药物难治性单侧复杂部分性发作中，使用非侵入性31P磁共振波谱成像（MRSI）在发作间期对癫痫病灶（7个颞叶海马病灶，1个额叶病灶）进行定位，以比较海马区或额叶区域。在所有8例病例中，癫痫病灶比同侧区域碱性更强（细胞内pH = 7.17±0.03），而对侧区域为（7.06±0.02，p < 0.01）；无机磷酸盐相对增加（是对侧的240±50%，8例中的7例，p < 0.01）；磷酸单酯相对减少（是对侧的68±9%，8例中的7例，p < 0.01）。其他磷代谢物呈对称分布（±10%）。31P MRSI在所有8例病例中均正确定位了癫痫病灶。相比之下，影像学正确定位了4例，单光子发射计算机断层扫描（SPECT）正确定位了2例。总之，31P MRSI是用于局灶性癫痫非侵入性临床评估的有用工具，并且能够准确地对癫痫病灶进行定位。
