Berkovic S F, Andermann F, Olivier A, Ethier R, Melanson D, Robitaille Y, Kuzniecky R, Peters T, Feindel W
Montreal Neurological Institute and Hospital, Quebec, Canada.
Ann Neurol. 1991 Feb;29(2):175-82. doi: 10.1002/ana.410290210.
The value of magnetic resonance imaging in the detection of hippocampal sclerosis has been controversial. We studied 10 patients aged 22.5 +/- 6.0 years with intractable temporal lobe epilepsy selected because of a history of a prolonged childhood convulsion, which is characteristic of a group of patients in whom hippocampal sclerosis is a constant finding. All 10 patients showed reduction in size of one hippocampus associated with increased signal intensity on T2-weighted magnetic resonance images. These changes were reliably detected on coronal spin-echo images, perpendicular to the long axis of the hippocampus. Appreciation of the normal imaging anatomy of the hippocampus allowed correct interpretation of the relative changes in signal intensities of the hippocampus and adjacent temporal horn on sequential echo images. The side of the abnormal hippocampus on magnetic resonance imaging accorded with the electroencephalographic localization in all 10 patients, and with the lateralization of the early convulsions in all 6 patients where this was known. Temporal lobectomy was performed in all 10 patients. Hippocampal sclerosis was confirmed in the 3 patients in whom hippocampal tissue was available for histological examination. The value of this technique was reinforced by the excellent postoperative results, with 80% being seizure free at a mean follow-up time of 33 +/- 4 months.
磁共振成像在检测海马硬化中的价值一直存在争议。我们研究了10例年龄在22.5±6.0岁的顽固性颞叶癫痫患者，这些患者因有童年期惊厥持续时间延长的病史而被选中，这是一组海马硬化为恒定表现的患者的特征。所有10例患者均显示一侧海马体积减小，T2加权磁共振图像上信号强度增加。这些变化在垂直于海马长轴的冠状自旋回波图像上能够可靠地检测到。了解海马的正常影像解剖结构有助于正确解读连续回波图像上海马及相邻颞角信号强度的相对变化。磁共振成像显示异常海马的一侧在所有10例患者中与脑电图定位一致，在已知早期惊厥侧化情况的所有6例患者中与早期惊厥的侧化一致。所有10例患者均接受了颞叶切除术。在有海马组织可用于组织学检查的3例患者中证实存在海马硬化。该技术的价值因术后效果良好而得到加强，平均随访时间33±4个月时80%的患者无癫痫发作。
