Lee Jong Woo, Wen Patrick Y, Hurwitz Shelley, Black Peter, Kesari Santosh, Drappatz Jan, Golby Alexandra J, Wells William M, Warfield Simon K, Kikinis Ron, Bromfield Edward B
Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Arch Neurol. 2010 Mar;67(3):336-42. doi: 10.1001/archneurol.2010.2.
To quantify size and localization differences between tumors presenting with seizures vs nonseizure neurological symptoms.
Retrospective imaging survey. We performed magnetic resonance imaging-based morphometric analysis and nonparametric mapping in patients with brain tumors.
University-affiliated teaching hospital.
One hundred twenty-four patients with newly diagnosed supratentorial glial tumors.
Volumetric and mapping methods were used to evaluate differences in size and location of the tumors in patients who presented with seizures as compared with patients who presented with other symptoms.
In high-grade gliomas, tumors presenting with seizures were smaller than tumors presenting with other neurological symptoms, whereas in low-grade gliomas, tumors presenting with seizures were larger. Tumor location maps revealed that in high-grade gliomas, deep-seated tumors in the pericallosal regions were more likely to present with nonseizure neurological symptoms. In low-grade gliomas, tumors of the temporal lobe as well as the insular region were more likely to present with seizures.
The influence of size and location of the tumors on their propensity to cause seizures varies with the grade of the tumor. In high-grade gliomas, rapidly growing tumors, particularly those situated in deeper structures, present with non-seizure-related symptoms. In low-grade gliomas, lesions in the temporal lobe or the insula grow large without other symptoms and eventually cause seizures. Quantitative image analysis allows for the mapping of regions in each group that are more or less susceptible to seizures.
量化出现癫痫发作的肿瘤与出现非癫痫性神经症状的肿瘤之间的大小和定位差异。
回顾性影像学调查。我们对脑肿瘤患者进行了基于磁共振成像的形态计量分析和非参数映射。
大学附属医院。
124例新诊断的幕上胶质肿瘤患者。
采用体积测量和映射方法评估出现癫痫发作的患者与出现其他症状的患者肿瘤在大小和位置上的差异。
在高级别胶质瘤中，出现癫痫发作的肿瘤比出现其他神经症状的肿瘤小，而在低级别胶质瘤中，出现癫痫发作的肿瘤更大。肿瘤定位图显示，在高级别胶质瘤中，胼胝体周围区域的深部肿瘤更有可能出现非癫痫性神经症状。在低级别胶质瘤中，颞叶以及岛叶区域的肿瘤更有可能出现癫痫发作。
肿瘤的大小和位置对其引发癫痫倾向的影响因肿瘤级别而异。在高级别胶质瘤中，快速生长的肿瘤，尤其是位于更深结构的肿瘤，表现为与癫痫无关的症状。在低级别胶质瘤中，颞叶或岛叶的病变在无其他症状的情况下逐渐增大，最终引发癫痫发作。定量图像分析能够绘制出每组中癫痫发作易感性较高或较低的区域。
