Namer I J, Waydelich R, Armspach J P, Hirsch E, Marescaux C, Grucker D
Institut de Physique Biologique (UPRESA 7004 CNRS), Faculté de Médecine, Strasbourg, France.
Neuroimage. 1998 May;7(4 Pt 1):304-13. doi: 10.1006/nimg.1998.0331.
In this study we compared the results of visual analysis of MR imaging with T2 relaxation time mapping of the mesial structures in a group of 97 patients with cryptogenic temporal lobe epilepsy. All patients underwent a clinical neurological examination, neuropsychological investigation, prolonged video-EEG monitoring, SPECT imaging, MR imaging, and T2 relaxation time mapping. T2 relaxation times were estimated with a Carr-Purcell-Meiboom-Gill pulse sequence with 48 echoes (15 to 720 ms). The mean T2 relaxation time value was 118.5 +/- 2 ms in the hippocampi and 120.3 +/- 1.9 ms in the amygdala of 21 healthy subjects used as controls. T2 relaxation mapping revealed mesial temporal sclerosis in 91.8% of the patients (often involving both the hippocampus and the amygdala) and evidenced bilateral involvement in 44.6% of the patients against 72.2 and 6.2%, respectively, for MR imaging. The ipsilateral and contralateral hippocampal T2 relaxation time values did significantly correlate with seizure frequency and the contralateral hippocampal T2 relaxation time value with the duration of epilepsy. In conclusion, this quantitative method is highly sensitive for the detection of mesial temporal sclerosis and permits a better evaluation of the apparently normal contralateral mesial structures.
在本研究中，我们比较了97例隐源性颞叶癫痫患者内侧结构的磁共振成像（MR）视觉分析结果与T2弛豫时间成像结果。所有患者均接受了临床神经学检查、神经心理学调查、长时间视频脑电图监测、单光子发射计算机断层扫描（SPECT）成像、MR成像及T2弛豫时间成像。采用具有48个回波（15至720毫秒）的Carr-Purcell-Meiboom-Gill脉冲序列估算T2弛豫时间。21名健康受试者作为对照，其海马体的平均T2弛豫时间值为118.5±2毫秒，杏仁核的平均T2弛豫时间值为120.3±1.9毫秒。T2弛豫时间成像显示91.8%的患者存在内侧颞叶硬化（常累及海马体和杏仁核），44.6%的患者为双侧受累，而MR成像显示的双侧受累比例分别为72.2%和6.2%。同侧和对侧海马体的T2弛豫时间值与癫痫发作频率显著相关，对侧海马体的T2弛豫时间值与癫痫病程相关。总之，这种定量方法对内侧颞叶硬化的检测高度敏感，且能更好地评估看似正常的对侧内侧结构。
