Bonilha L, Kobayashi E, Rorden C, Cendes F, Li L M
Neuroimaging Laboratory, Department of Neurology, State University of Campinas, Brazil.
J Neurol Neurosurg Psychiatry. 2003 Dec;74(12):1627-30. doi: 10.1136/jnnp.74.12.1627.
The objective of this study was to assess the volumes of medial temporal lobe structures using high resolution magnetic resonance images from patients with chronic refractory medial temporal lobe epilepsy (MTLE).
We studied 30 healthy subjects, and 25 patients with drug refractory MTLE and unilateral hippocampal atrophy (HA). We used T1 magnetic resonance images with 1 mm isotropic voxels, and applied a field non-homogeneity correction and a linear stereotaxic transformation into a standard space. The structures of interest are the entorhinal cortex, perirhinal cortex, parahippocampal cortex, temporopolar cortex, hippocampus, and amygdala. Structures were identified by visual examination of the coronal, sagittal, and axial planes. The threshold of statistical significance was set to p<0.05.
Patients with right and left MTLE showed a reduction in volume of the entorhinal (p<0.001) and perirhinal (p<0.01) cortices ipsilateral to the HA, compared with normal controls. Patients with right MTLE exhibited a significant asymmetry of all studied structures; the right hemisphere structures had smaller volume than their left side counterparts. We did not observe linear correlations between the volumes of different structures of the medial temporal lobe in patients with MTLE.
Patients with refractory MTLE have damage in the temporal lobe that extends beyond the hippocampus, and affects the regions with close anatomical and functional connections to the hippocampus.
本研究的目的是利用慢性难治性内侧颞叶癫痫（MTLE）患者的高分辨率磁共振图像评估内侧颞叶结构的体积。
我们研究了30名健康受试者以及25名患有药物难治性MTLE且单侧海马萎缩（HA）的患者。我们使用了体素各向同性为1毫米的T1磁共振图像，并应用场不均匀性校正和线性立体定向变换将其转换到标准空间。感兴趣的结构包括内嗅皮质、嗅周皮质、海马旁皮质、颞极皮质、海马和杏仁核。通过对冠状面、矢状面和轴位面的视觉检查来识别结构。统计学显著性阈值设定为p<0.05。
与正常对照组相比，右侧和左侧MTLE患者患侧HA同侧的内嗅皮质（p<0.001）和嗅周皮质（p<0.01）体积减小。右侧MTLE患者所有研究结构均表现出明显的不对称性；右侧半球结构的体积小于左侧对应结构。我们未观察到MTLE患者内侧颞叶不同结构体积之间的线性相关性。
难治性MTLE患者的颞叶损伤超出海马体，且影响与海马体有密切解剖和功能联系的区域。
