Rugg-Gunn Fergus J, Boulby Philip A, Symms Mark R, Barker Gareth J, Duncan John S
The MRI Unit, National Society for Epilepsy, Chalfont St Peter, Gerrards Cross, Bucks, SL9 0RJ, UK.
Neuroimage. 2006 May 15;31(1):39-50. doi: 10.1016/j.neuroimage.2005.11.034. Epub 2006 Feb 7.
The neocortices of 10 patients with partial seizures and acquired lesions, 14 patients with malformations of cortical development (MCD) and 33 patients with partial seizures and normal conventional MRI were quantitatively evaluated using whole brain double inversion recovery imaging (DIR) and Statistical Parametric Mapping (SPM). Compared to a group of 30 control subjects, DIR and objective voxel-by-voxel statistical comparison identified regions of significantly abnormal DIR signal intensity (DSI) in 9 out of 10 patients with acquired nonprogressive cerebral lesions and partial seizures. In all 9 patients, the areas of abnormal DSI concurred with abnormalities identified on visual inspection of conventional MRI. In all 14 patients with MCD, SPM detected regions of significantly abnormal DSI; all of which corresponded to abnormalities identified on visual inspection of conventional MRI. In addition, in both groups, there were areas that were normal on conventional imaging, which demonstrated abnormal DSI. Voxel-by-voxel statistical analysis identified significantly abnormal DSI in 15 of the 33 patients with cryptogenic focal epilepsy. In 10 of these, the areas of abnormal DSI concurred with epileptic EEG abnormality and clinical seizure semiology. Group analysis of MRI-negative patients with electroclinical seizure onset localising to the left temporal and left and right frontal regions revealed significantly abnormal DSI within the white matter of each respective lobe. DIR analysed using SPM was sensitive in patients with MCDs and acquired cerebral damage. Significant abnormalities in DSI in individual and grouped MRI-negative patients suggest that occult epileptogenic cerebral lesions are associated with subtle structural abnormalities. DIR is, therefore, a useful quantitative MRI technique for characterising epileptic foci and may contribute to presurgical evaluation.
使用全脑双反转恢复成像（DIR）和统计参数映射（SPM）对10例部分性癫痫伴获得性病变患者、14例皮质发育畸形（MCD）患者和33例部分性癫痫且常规MRI正常的患者的新皮质进行了定量评估。与30名对照受试者组成的小组相比，DIR和客观的逐体素统计比较在10例获得性非进行性脑病变和部分性癫痫患者中的9例中识别出DIR信号强度（DSI）显著异常的区域。在所有9例患者中，DSI异常区域与常规MRI视觉检查发现的异常一致。在所有14例MCD患者中，SPM检测到DSI显著异常的区域；所有这些区域都与常规MRI视觉检查发现的异常相对应。此外，在两组中，常规成像正常的区域显示出DSI异常。逐体素统计分析在33例隐源性局灶性癫痫患者中的15例中识别出DSI显著异常。其中10例患者中，DSI异常区域与癫痫性脑电图异常和临床发作症状学一致。对电临床发作起始定位于左颞叶以及左右额叶区域的MRI阴性患者进行分组分析，发现在每个相应脑叶的白质内DSI显著异常。使用SPM分析的DIR对MCD患者和获得性脑损伤患者敏感。个体和分组的MRI阴性患者中DSI的显著异常表明隐匿性致痫性脑病变与细微的结构异常有关。因此，DIR是一种用于表征癫痫灶的有用的定量MRI技术，可能有助于术前评估。
