Zhang Quan, Li Qiong, Zhang Jing, Zhang Yunting
Department of Radiology, General Hospital of Tianjin Medical University, Tianjin, China.
J Comput Assist Tomogr. 2011 May-Jun;35(3):406-10. doi: 10.1097/RCT.0b013e318219c2b6.
To determine whether the finding of hyperintense hippocampal signal intensity on double inversion recovery (DIR) magnetic resonance imaging is correlated with hippocampal volume loss and metabolic abnormalities in patients with mesial temporal lobe epilepsy (MTLE).
This retrospective study had institutional review board approval, and informed consent was obtained. Thirteen patients with unilateral hippocampal sclerosis and 13 age-matched healthy control subjects were included. Quantitative assessment for hippocampus of the patients and the control subjects was determined, including DIR, 3-dimensional T1-weighted imaging and proton magnetic resonance spectroscopy. Hippocampal relative signal intensity on DIR images (RSIDIR), volumes, and N-acetylaspartate-to-choline and creatine/phosphocreatine ratios were measured during one magnetic resonance imaging session, and asymmetry indexes (AI) of bilateral hippocampi were calculated. Hippocampal RSIDIR and AIDIR were compared between the patients and the control subjects. The RSIDIR and AIDIR were further correlated with the quantitative MR measures and with the age at onset and duration of MTLE. Statistical analyses were performed with Student t test, 1-way analysis of variance, and Pearson correlation.
On DIR images, the hippocampi ipsilateral to the seizure focus demonstrated relatively extreme hyperintensity. The ipsilateral hippocampi showed significantly increased RSIDIR compared with contralateral hippocampi and the healthy subjects (F = 197.956, P < 0.001). The hippocampal AIDIR in the patients was also significantly higher than that in the control group (t = 24.896, P < 0.001). Significant Pearson correlations (2-tailed) were obtained between the RSIDIR and the volume of the ipsilateral hippocampi (r = -0.762, P < 0.01) and between the RSIDIR and duration of epilepsy (r = 0.557, P < 0.05). Moreover, there were significant correlations between the AIDIR and the AIvolume (r = 0.609, P < 0.05) and between the AIDIR and the duration of epilepsy (r = 0.610, P < 0.05). However, no significant correlations of hippocampal DIR measures with proton magnetic resonance spectroscopy were obtained.
Double inversion recovery imaging of the brain can yield complementary information about hippocampal pathology and efficiently lateralize the hippocampal sclerosis in patients with MTLE.
确定在双侧反转恢复（DIR）磁共振成像上发现的海马高强度信号是否与内侧颞叶癫痫（MTLE）患者的海马体积损失和代谢异常相关。
这项回顾性研究获得了机构审查委员会的批准，并获得了知情同意。纳入了13例单侧海马硬化患者和13例年龄匹配的健康对照者。对患者和对照者的海马进行定量评估，包括DIR、三维T1加权成像和质子磁共振波谱。在一次磁共振成像检查中测量DIR图像上的海马相对信号强度（RSIDIR）、体积以及N-乙酰天门冬氨酸与胆碱和肌酸/磷酸肌酸的比率，并计算双侧海马的不对称指数（AI）。比较患者和对照者之间的海马RSIDIR和AIDIR。RSIDIR和AIDIR进一步与定量磁共振测量值以及MTLE的发病年龄和病程相关。采用学生t检验、单因素方差分析和Pearson相关性分析进行统计分析。
在DIR图像上，癫痫灶同侧的海马表现出相对极端的高强度。与对侧海马和健康受试者相比，同侧海马的RSIDIR显著增加（F = 197.956，P < 0.001）。患者的海马AIDIR也显著高于对照组（t = 24.896，P < 0.001）。在RSIDIR与同侧海马体积之间（r = -0.762，P < 0.01）以及RSIDIR与癫痫病程之间（r = 0.557，P < 0.05）获得了显著的Pearson相关性（双侧）。此外，AIDIR与AI体积之间（r = 0.609，P < 0.05）以及AIDIR与癫痫病程之间（r = 0.610，P < 0.05）存在显著相关性。然而，未获得海马DIR测量值与质子磁共振波谱之间的显著相关性。
脑部双侧反转恢复成像可以提供有关海马病理的补充信息，并有效地对MTLE患者的海马硬化进行定位。
