颞叶癫痫患者颅内血液灌注的改变：一项动脉自旋标记研究
Alteration of intracranial blood perfusion in temporal lobe epilepsy, an arterial spin labeling study.
作者信息
Rahimzadeh Hossein, Kamkar Hadi, Hoseini-Tabatabaei Narges, Mobarakeh Neda Mohammadi, Habibabadi Jafar Mehvari, Hashemi-Fesharaki Seyed-Sohrab, Nazem-Zadeh Mohammad-Reza
机构信息
Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran.
Department of Biomedical Engineering and Medical Physics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Heliyon. 2023 Mar 24;9(4):e14854. doi: 10.1016/j.heliyon.2023.e14854. eCollection 2023 Apr.
BACKGROUND
A critical necessity before surgical resection in mesial temporal lobe epilepsy (mTLE) is lateralizing the seizure focus in the temporal lobe. This study aimed to investigate the differences in perfusion pattern changes in right and left mTLE.
METHODS
42 mTLE patients (22 left and 20 right mTLE) and 14 controls were surveyed with pulsed arterial spin labeling at 3.0 T. The mean cerebral blood flow (CBF) and asymmetry index (AI) were calculated in the bilateral temporal lobe, amygdala, hippocampus, parahippocampus, and nine bilateral vascular territories ROIs. The alterations in whole-brain CBF were identified using statistical parametric mapping (SPM).
RESULTS
CBF decreased in ipsilateral sides in both epilepsy subcohorts, with right mTLE showing a significant difference in most ROIs while left mTLE exhibiting no significant change. CBF comparison of left mTLE and controls showed a significant drop in ROI analysis in left middle temporal and left intermediate posterior cerebral artery and in AI analysis in parahippocampus, distal anterior cerebral artery, distal middle cerebral artery, and intermediate anterior cerebral artery. CBF hypoperfusion was seen in ROI analysis in the left intermediate anterior cerebral artery, left middle temporal, right middle temporal, left superior temporal in the right mTLE compared to controls. Left mTLE CBF differed significantly from right mTLE CBF in right distal middle cerebral artery ROI and AI of proximal middle cerebral artery.
CONCLUSION
Our result revealed that mTLE affects extratemporal regions and both mTLE subcohorts with different perfusion patterns, which may enhance the performance of preoperative MRI assessment in lateralization procedures.
背景
内侧颞叶癫痫（mTLE）手术切除前的一项关键需求是确定颞叶癫痫发作的病灶位置。本研究旨在探讨右侧和左侧mTLE灌注模式变化的差异。
方法
对42例mTLE患者（22例左侧mTLE和20例右侧mTLE）及14名对照者进行3.0T脉冲动脉自旋标记检查。计算双侧颞叶、杏仁核、海马、海马旁回以及9个双侧血管区域感兴趣区（ROI）的平均脑血流量（CBF）和不对称指数（AI）。使用统计参数映射（SPM）识别全脑CBF的变化。
结果
两个癫痫亚组的同侧CBF均降低，右侧mTLE在大多数ROI中显示出显著差异，而左侧mTLE无显著变化。左侧mTLE与对照者的CBF比较显示，在左侧颞中回和左侧大脑中后动脉中间段的ROI分析以及海马旁回、大脑前动脉远端、大脑中动脉远端和大脑前动脉中间段的AI分析中显著下降。与对照者相比，右侧mTLE在左侧大脑前动脉中间段、左侧颞中回、右侧颞中回、左侧颞上回的ROI分析中出现CBF灌注不足。左侧mTLE的CBF在右侧大脑中动脉远端ROI和大脑中动脉近端AI方面与右侧mTLE有显著差异。
结论
我们的结果表明，mTLE会影响颞叶外区域，且两个mTLE亚组具有不同的灌注模式，这可能会提高术前MRI评估在定位过程中的性能。
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