Connelly A, Jackson G D, Duncan J S, King M D, Gadian D G
Radiology and Physics Unit, Institute of Child Health, Queen Square, London, UK.
Neurology. 1994 Aug;44(8):1411-7. doi: 10.1212/wnl.44.8.1411.
We used proton magnetic resonance spectroscopy (1H MRS) to investigate the temporal lobes of 25 patients with temporal lobe epilepsy. Spectra were obtained from 2 x 2 x 2 cm cubes in the medial region of the temporal lobe, and were analyzed on the basis of signals from N-acetylaspartate (NAA), creatine + phosphocreatine (Cr), and choline-containing compounds (Cho). In comparison with control subjects, the temporal lobes ipsilateral to the seizure focus showed a mean reduction of 22% in the NAA signal, with a 15% increase in the Cr signal and a 25% increase in the Cho signal. There were smaller effects in the contralateral temporal lobes. These spectral abnormalities may reflect neuronal loss or damage, together with reactive astrocytosis. The NAA/Cho+Cr ratio was abnormally low in 88% of the patients, 40% showing bilateral effects. On the basis of the NAA/Cho+Cr ratio, we correctly achieved lateralization in 15 cases, with three incorrect. Two of the incorrect lateralizations also had imaging abnormalities on the contralateral side, and the other had severe bilateral abnormalities on MRS. We conclude that 1H MRS provides useful information in the preoperative investigation of patients with temporal lobe epilepsy, contributing to lateralization and detecting bilateral abnormalities.
我们使用质子磁共振波谱（1H MRS）对25例颞叶癫痫患者的颞叶进行了研究。从颞叶内侧区域2×2×2 cm的立方体中获取波谱，并根据N-乙酰天门冬氨酸（NAA）、肌酸+磷酸肌酸（Cr）和含胆碱化合物（Cho）的信号进行分析。与对照组相比，癫痫灶同侧的颞叶NAA信号平均降低22%，Cr信号增加15%，Cho信号增加25%。对侧颞叶的影响较小。这些波谱异常可能反映了神经元丢失或损伤以及反应性星形细胞增生。88%的患者NAA/Cho+Cr比值异常低，40%表现为双侧异常。基于NAA/Cho+Cr比值，我们在15例中正确实现了定侧，3例错误。其中2例错误定侧的对侧也有影像学异常，另一例在MRS上有严重的双侧异常。我们得出结论，1H MRS在颞叶癫痫患者的术前检查中提供了有用信息，有助于定侧并检测双侧异常。
