Lehéricy S, Semah F, Hasboun D, Dormont D, Clémenceau S, Granat O, Marsault C, Baulac M
Department of Neuroradiology, Bâtiment Tête, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Neuroradiology. 1997 Nov;39(11):788-96. doi: 10.1007/s002340050507.
MRI was performed in 222 consecutive adult patients with temporal lobe epilepsy of varying severity from January 1991 to May 1993. The diagnosis of hippocampal sclerosis was established visually by three independent observers. The accuracy of visual assessment of hippocampal asymmetry was compared with volumetric measurements. Neuropathological correlations were obtained in 63 patients with refractory seizures. Temporal lobe abnormalities were observed in 180 patients (81%) as follows: hippocampal sclerosis in 122 (55%); developmental abnormalities in 16 (7.2%); tumours in 15 (6.8%); scars in 11 (5%); cavernous angiomas in 10 (4.5%); miscellaneous lesions in 6. MRI was normal or showed unrelated changes in 42 patients (19%). Visual assessment correctly lateralised hippocampal sclerosis in 79 of the 84 patients measured (94%). Temporal lobectomy confirmed the MRI data (side and aetiology) in all 63 operated patients. Patients with normal MRI had an older age of seizure onset and were more often drug-responsive than patients with hippocampal sclerosis. MRI showed temporal lobe abnormalities in 81% of epileptic patients with varying severity with good neuropathological correlation. Patients with normal MRI had a less severe form of the disease.
1991年1月至1993年5月，对222例病情轻重不一的成年颞叶癫痫患者进行了磁共振成像（MRI）检查。由三名独立观察者通过肉眼观察确定海马硬化的诊断。将海马不对称性的肉眼评估准确性与体积测量结果进行比较。对63例难治性癫痫患者进行了神经病理学相关性分析。180例患者（81%）观察到颞叶异常，具体如下：海马硬化122例（55%）；发育异常16例（7.2%）；肿瘤15例（6.8%）；瘢痕11例（5%）；海绵状血管瘤10例（4.5%）；其他病变6例。42例患者（19%）MRI正常或显示无关改变。在测量的84例患者中，肉眼评估正确定位海马硬化的有79例（94%）。63例接受手术的患者，颞叶切除术证实了MRI数据（病变侧别及病因）。MRI正常的患者癫痫发作起始年龄较大，且比海马硬化患者更常对药物有反应。MRI显示81%病情轻重不一的癫痫患者存在颞叶异常，与神经病理学有良好的相关性。MRI正常的患者病情较轻。
