Kimura Yukio, Sato Noriko, Saito Yuko, Ito Kimiteru, Kamiya Kouhei, Nakata Yasuhiro, Watanabe Masako, Maikusa Norihide, Matsuda Hiroshi, Sugimoto Hideharu
Departments of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan.
Department of Radiology, Jichi Medical University, Tochigi, Japan.
J Neuroimaging. 2015 Mar-Apr;25(2):175-183. doi: 10.1111/jon.12106. Epub 2014 Mar 5.
Amygdala enlargement (AE) has been reported as an epileptogenic focus in subtypes of temporal lobe epilepsy (TLE). The purpose of this study was to investigate the clinical, morphological, and pathological characteristics of AE.
We retrospectively reviewed the clinical data and imaging findings of 23 TLE patients with ipsilateral AE. We performed morphological MR analyses using FreeSurfer and voxel-based morphometry (VBM) in 14 of the 23 patients and in 20 controls whose images were obtained by a 3.0-Tesla MRI. A pathological study was also performed in 2 patients who underwent operations.
All patients became seizure free or shSowed dramatic improvement by medical therapy except for two. They received operations and their pathology revealed that both patients had cortical dysplasia in from the amygdala to the ipsilateral temporal pole. The FreeSurfer analysis showed a significant difference in the amygdala volumes between the affected and nonaffected sides. VBM revealed significant increases of gray matter volumes of the temporal pole on the side of AE in seven of the 14 patients with AE (50%).
Cortical dysplasia may be one of the pathological diagnoses in AE, and in some patients it may extend to the temporal pole.
杏仁核增大（AE）已被报道为颞叶癫痫（TLE）亚型中的致痫灶。本研究旨在探讨AE的临床、形态学和病理学特征。
我们回顾性分析了23例同侧AE的TLE患者的临床资料和影像学表现。我们对23例患者中的14例以及20例通过3.0特斯拉MRI获得图像的对照者进行了使用FreeSurfer和基于体素的形态学测量（VBM）的形态学MR分析。还对2例接受手术的患者进行了病理学研究。
除2例患者外，所有患者通过药物治疗均无癫痫发作或有显著改善。他们接受了手术，病理显示这2例患者均有从杏仁核到同侧颞叶极的皮质发育异常。FreeSurfer分析显示患侧和未患侧杏仁核体积有显著差异。VBM显示14例AE患者中有7例（50%）AE侧颞叶极灰质体积显著增加。
皮质发育异常可能是AE的病理诊断之一，在一些患者中可能延伸至颞叶极。
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