Cendes F, Andermann F, Gloor P, Evans A, Jones-Gotman M, Watson C, Melanson D, Olivier A, Peters T, Lopes-Cendes I
Department of Neurology and Neurosurgery, McGill University, Montreal, PQ, Canada.
Neurology. 1993 Apr;43(4):719-25. doi: 10.1212/wnl.43.4.719.
We performed MRI volumetric measurements of the amygdala (AM), the hippocampal formation (HF), and the anterior temporal lobe in a group of 30 patients with intractable temporal lobe epilepsy (TLE) and in seven patients with extratemporal lobe foci. Measurements were analyzed with a semiautomated software program and the results compared with those of normal controls and correlated with the findings of all other investigations. In particular, we compared the results with the lateralization of epileptic abnormalities in the EEG. Volumetric studies of AM and HF showed lateralization of measurable atrophy consistent with that derived from extracranial and intracranial EEG examinations. The HF volumes were more sensitive and provided a lateralization in 87%. Combined measurements of AM and HF showed lateralization in 93%, always congruent with the results of EEG lateralization. This slight but important additional improvement in discrimination justifies using AM measurements in MRI volumetric studies of mesial temporal structures. Volumetric studies combined with other currently employed noninvasive techniques may diminish the need for invasive methods of investigation in patients with TLE.
我们对30例顽固性颞叶癫痫（TLE）患者和7例颞叶外病灶患者进行了杏仁核（AM）、海马结构（HF）和颞叶前部的MRI容积测量。测量结果采用半自动软件程序进行分析，并将结果与正常对照组进行比较，并与所有其他检查结果相关联。特别是，我们将结果与脑电图中癫痫异常的定位进行了比较。AM和HF的容积研究显示，可测量萎缩的定位与颅外和颅内脑电图检查结果一致。HF体积更敏感，87%可实现定位。AM和HF的联合测量显示93%可实现定位，且总是与脑电图定位结果一致。这种在辨别力上轻微但重要的额外改善证明了在颞叶内侧结构的MRI容积研究中使用AM测量的合理性。容积研究与其他目前采用的非侵入性技术相结合，可能会减少TLE患者对侵入性检查方法的需求。
