Radiology and Physics Unit, UCL Institute of Child Health, University College London, London, UK.
Epilepsy Res. 2010 Feb;88(2-3):221-30. doi: 10.1016/j.eplepsyres.2009.11.013. Epub 2009 Dec 30.
Convulsive status epilepticus (SE) is a common medical neurological emergency and is associated with hippocampal injury and the subsequent development of epilepsy. However, pathophysiological mechanisms that underlie injury remain unclear, and a clinically useful prognostic biomarker of at-risk patients remains elusive. We hypothesised that non-invasive quantitative multi-parametric MRI characterisation of the early time course in the lithium-pilocarpine rat model would provide insight into pathophysiological processes, and may help to develop a non-invasive prognostic marker of hippocampal injury. T(1), T(2), apparent diffusion coefficient (ADC), and cerebral blood flow (CBF) were measured before and after SE on days 0, 1, 2, 3, 7, 14 and 21. Hippocampal volume measurements were used to assess final structural outcome. MRI changes were found in the parietal cortex, hippocampus, piriform cortex, and thalamus. Each of the regions displayed time-dependent changes, and returned to baseline levels by Day 7. Hippocampal measurements peaked on Day 2, and further analysis revealed that the magnitude of these peak changes was predictive of the hippocampal volumes on Day 21. This time course is consistent with cell death and an inflammatory process. The maximal changes provide a potential clinically useful prognostic marker of final hippocampal volume.
癫痫持续状态（SE）是一种常见的医学神经系统急症，与海马损伤和随后的癫痫发作有关。然而，损伤的病理生理机制仍不清楚，有临床应用价值的高危患者的预后生物标志物仍难以捉摸。我们假设，锂-匹罗卡品大鼠模型中早期时间过程的无创定量多参数 MRI 特征将提供对病理生理过程的深入了解，并可能有助于开发海马损伤的无创预后标志物。在 SE 后 0、1、2、3、7、14 和 21 天的 0 天、1 天、2 天、3 天、7 天、14 天和 21 天测量 T1、T2、表观扩散系数（ADC）和脑血流（CBF）。使用海马体积测量来评估最终的结构结果。在顶叶皮层、海马、梨状皮层和丘脑发现了 MRI 变化。每个区域都显示出时间依赖性变化，并在第 7 天恢复到基线水平。海马测量值在第 2 天达到峰值，进一步分析表明，这些峰值变化的幅度可以预测第 21 天的海马体积。这种时程与细胞死亡和炎症过程一致。最大变化提供了一个潜在的有临床应用价值的最终海马体积预后标志物。
