Breiter S N, Arroyo S, Mathews V P, Lesser R P, Bryan R N, Barker P B
Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287.
AJNR Am J Neuroradiol. 1994 Feb;15(2):373-84.
To evaluate the ability of proton MR spectroscopy to detect metabolic abnormalities in the seizure focus of humans with epilepsy.
Single-voxel MR spectroscopy and MR imaging was performed in a group of 13 patients with a variety of seizure disorders and in the temporal lobes of 14 healthy volunteers. Signals from choline, creatine, N-acetyl-L-aspartate, and lactate were quantitated in both the epileptogenic focus and the contralateral brain region.
In normal temporal lobe, concentrations of choline, creatine, and N-acetyl-L-aspartate were 2.0 +/- 0.7, 7.8 +/- 1.9, and 11.0 +/- 2.1 mumol/g wet weight, respectively, with no detectable lactate. In all patients, a reduction in the N-acetyl-L-aspartate signal was observed in the electrically defined (scalp electroencephalogram) seizure focus compared with the mirror-image contralateral side. Lactate was elevated only in patients who had seizures during or immediately before the MR examination. Seven of 13 patients studied had normal MR examinations.
Proton spectroscopy demonstrates alterations in N-acetyl-L-aspartate and lactate levels that can be used to locate the epileptogenic focus and may be a useful adjunctive diagnostic technique for the evaluation of patients with seizures who are eligible for resective surgery.
评估质子磁共振波谱检测癫痫患者发作灶代谢异常的能力。
对13例患有各种癫痫疾病的患者以及14名健康志愿者的颞叶进行了单体素质子磁共振波谱和磁共振成像检查。对致痫灶和对侧脑区的胆碱、肌酸、N - 乙酰天门冬氨酸和乳酸信号进行了定量分析。
在正常颞叶中，胆碱、肌酸和N - 乙酰天门冬氨酸的浓度分别为2.0±0.7、7.8±1.9和11.0±2.1μmol/g湿重，未检测到乳酸。在所有患者中，与镜像对侧相比，在电定义（头皮脑电图）的发作灶中观察到N - 乙酰天门冬氨酸信号降低。仅在磁共振检查期间或检查前立即发作的患者中乳酸水平升高。所研究的13例患者中有7例磁共振检查结果正常。
质子波谱显示N - 乙酰天门冬氨酸和乳酸水平的改变，可用于定位致痫灶，对于适合进行切除性手术的癫痫患者评估可能是一种有用的辅助诊断技术。
