Shao Xiao-Li, Zhou Zhong-Shu, Hong Wen
Department of Pediatrics, People's Hospital of Shaoxing, Shaoxing, Zhejiang 312000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2010 Jun;12(6):425-8.
This study examined the biochemical metabolism by proton magnetic resonance spectroscopy ('H-MRS) in order to explore the value of 'H-MRS in idiopathic epilepsy in children.
Thirty-three children with idiopathic epilepsy (14 cases with history of febrile seizures and 19 cases without) and six normal controls experienced MRI of the skull and brain and single-voxel 'H-MRS examinations of the hippocampi-temporal lobe. The signal intensities of N-acetylaspartate (NAA), eatine+phosphocreatine (Cr), choline-containing compounds (Cho) and lactate (Lac) and the ratios of NAA/ (Cho+Cr) and Lac/Cr were compared between the patients and normal controls.
MRI examination showed that only one child with epilepsy had myelin dysplasia. 'H-MRS examination showed that the ratio of NAA/ (Cho+Cr) in the epilepsy group was lower than that in the control group (0.64+/-0.07 vs 0.73+/-0.05; P<0.01). The epileptic children with history of febrile seizures had a more decreased ratio of NAA/ (Cho+Cr) compared with those without the history (0.61+/-0.07 vs 0.66+/-0.06; P<0.05). There were no significant differences in the ratio of Lac/Cr between the epilepsy and the control groups.
'H-MRS may provide early information on brain injury sensitively and non-invasively in children with epilepsy. It may be used for diagnosis and prognosis evaluation of epilepsy.
本研究通过质子磁共振波谱（¹H-MRS）检测生物化学代谢情况，以探讨¹H-MRS在儿童特发性癫痫中的应用价值。
33例特发性癫痫患儿（14例有热性惊厥病史，19例无热性惊厥病史）及6例正常对照者接受了头颅及脑部MRI检查以及海马-颞叶单体素¹H-MRS检查。比较患者与正常对照者之间N-乙酰天门冬氨酸（NAA）、肌酸+磷酸肌酸（Cr）、含胆碱化合物（Cho）和乳酸（Lac）的信号强度，以及NAA/（Cho+Cr）和Lac/Cr的比值。
MRI检查显示，仅1例癫痫患儿存在髓鞘发育异常。¹H-MRS检查显示，癫痫组NAA/（Cho+Cr）比值低于对照组（0.64±0.07 vs 0.73±0.05；P<0.01）。有热性惊厥病史的癫痫患儿NAA/（Cho+Cr）比值较无热性惊厥病史者降低更明显（0.61±0.07 vs 0.66±0.06；P<0.05）。癫痫组与对照组之间Lac/Cr比值无显著差异。
¹H-MRS可敏感、无创地为癫痫患儿提供脑损伤的早期信息。它可用于癫痫的诊断和预后评估。
