Feizhou Du, Jing Guan, Peng Wang, Jialing Wu, Rui Jiang
Department of Radiology, The General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China.
Exp Ther Med. 2020 Nov;20(5):98. doi: 10.3892/etm.2020.9228. Epub 2020 Sep 17.
Diagnosing epilepsy at the early stages is pivotal in the prevention and subsequent treatment of major epileptic events. MRI has been previously demonstrated to be beneficial in optimizing diagnostic efficacy and the subsequent treatment of epilepsy. In the present study, morphometric and textural analysis was performed pre-operatively on dynamic contrast-enhanced (Dce)-magnetic resonance imaging (MRI)-guided lesions in patients with epilepsy. The diagnostic efficacies of MRI and Dce-MRI were evaluated in 280 patients with epilepsy. The performance of Dce-MRI (n=140) was compared with that of classic MRI (n=140) in the analysis of the morphometric and textural features of the lesions, and the accuracy of mapping to regions of the brain that were potentially associated with the region of seizure onset was also investigated. Diagnostic quality was evaluated by comparing the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the hippocampus, the grey-white matter contrast and the morphometric and textural analysis of epileptogenic lesions. Data from the present study demonstrated that the regions of suspected epileptic activity in the brain were mapped more successfully using Dce-MRI compared with MRI. Image quality obtained by Dce-MRI was adequate for the detection of epileptic lesions, including those of focal cortical dysplasia or periventricular nodular heterotopia (PNH). The diagnostic value of Dce-MRI for subtle lesions such as PNH was found to be more efficient compared with that of MRI due to the significantly increased SNR and CNR. In addition, Dce-MRI exhibited higher accuracy compared with MRI for the identification of cortical lesions and for the mapping to the zone of suspected seizure onset. Dce-MRI also exhibited higher sensitivity and specificity in the diagnosis of patients with epilepsy and mapping to the lesions associated with epilepsy compared with MRI. These findings indicate that Dce-MRI is a feasible technique that may be beneficial in the diagnosis and subsequent management of patients with epilepsy.
早期诊断癫痫对于预防重大癫痫发作及后续治疗至关重要。先前已证明磁共振成像（MRI）有助于优化癫痫的诊断效果及后续治疗。在本研究中，对癫痫患者术前动态对比增强（Dce）-磁共振成像（MRI）引导下的病变进行了形态学和纹理分析。对280例癫痫患者评估了MRI和Dce-MRI的诊断效能。在分析病变的形态学和纹理特征方面，将Dce-MRI（n = 140）的表现与经典MRI（n = 140）进行了比较，并且还研究了映射到可能与癫痫发作起始区域相关的脑区的准确性。通过比较海马的信噪比（SNR）和对比噪声比（CNR）、灰白质对比度以及癫痫病灶的形态学和纹理分析来评估诊断质量。本研究数据表明，与MRI相比，使用Dce-MRI能更成功地在大脑中映射出疑似癫痫活动区域。Dce-MRI获得的图像质量足以检测癫痫病灶，包括局灶性皮质发育不良或脑室周围结节性异位（PNH）病灶。由于SNR和CNR显著增加，发现Dce-MRI对PNH等细微病灶的诊断价值比MRI更高。此外，在识别皮质病灶以及映射到疑似癫痫发作起始区域方面，Dce-MRI比MRI表现出更高的准确性。与MRI相比，Dce-MRI在癫痫患者诊断及映射到与癫痫相关的病灶方面也表现出更高的敏感性和特异性。这些发现表明，Dce-MRI是一种可行的技术，可能对癫痫患者的诊断及后续管理有益。
Zotero 插件
