Dupont S, Baulac M
Unité d'épileptologie, Clinique Neurologique, Hôpital Pitié-Salpêtrière, 47 boulevard de l'Hôpital, 75651 Paris Cedex 13, France.
Rev Neurol (Paris). 2004 Jun;160 Spec No 1:5S91-7.
The development of MRI has modified clinical practices for patients with epilepsy. MRI examinations are highly contributive to the detection of structural brain abnormalities, and have a major impact on the management of patients with epilepsy. In addition to its major diagnostic role, MRI may help to assess prognosis in patients with refractory partial epilepsy. Structural abnormalities such as hippocampal sclerosis or malformations of cortical development are associated with medically refractory epilepsy. Furthermore, finding a focal lesion on MRI is a good prognostic factor in refractory patients who are candidates for surgery. The sensitivity of MRI to detect small brain lesions is currently excellent, but may be further improved by the use of high-resolution imaging, and new techniques such as quantitative methods or statistical parametric mapping (SPM). In the future, new emerging MR techniques will undoubtedly greatly contribute to improved presurgical management of patients with refractory partial epilepsy.
磁共振成像(MRI)的发展改变了癫痫患者的临床治疗方式。MRI检查对发现脑部结构异常有很大帮助,对癫痫患者的管理有重大影响。除了其主要的诊断作用外,MRI还可有助于评估难治性部分性癫痫患者的预后。海马硬化或皮质发育畸形等结构异常与药物难治性癫痫有关。此外,在MRI上发现局灶性病变是适合手术的难治性患者的一个良好预后因素。目前MRI检测小脑病变的敏感性极佳,但通过使用高分辨率成像以及定量方法或统计参数映射(SPM)等新技术,其敏感性可能会进一步提高。未来,新出现的MR技术无疑将极大地有助于改善难治性部分性癫痫患者的术前管理。