Kuzniecky R, Hugg J W, Hetherington H, Butterworth E, Bilir E, Faught E, Gilliam F
UAB Epilepsy Center, Department of Neurology and Center for Nuclear Imaging Research, University of Alabama at Birmingham, USA.
Neurology. 1998 Jul;51(1):66-71. doi: 10.1212/wnl.51.1.66.
To determine the relative utility of 1H MRSI and hippocampal volumetry for the lateralization of mesial temporal lobe epilepsy (MTLE) in patients with intractable epilepsy.
MTLE is the most common partial-onset seizure disorder in patients undergoing temporal lobe epilepsy surgery. MR volumetry and spectroscopy are reliable preoperative imaging techniques for the lateralization of MTLE.
We analyzed the 1H MRSI and hippocampal formation volumes preoperatively in 30 consecutive patients who had undergone temporal lobectomy.
Volumetry correctly lateralized the side of surgery in 93% of patients and 1H MRSI did so in 97% of patients. Incorrect lateralization occurred by volumetry in two patients and by 1H MRSI in one patient. Concordance between all MRI modalities was 73%. Pearson's analysis revealed no correlation between the degree of hippocampal volume loss and the creatine-to-N-acetylated-compounds ratio.
Volumetry and 1H MRSI correctly lateralized most patients with MTLE and complement each other in final lateralization. The lack of correlation between the severity of volume loss and the degree of metabolic disturbance suggests that the techniques examine distinct pathophysiologic processes in MTLE.
确定1H磁共振波谱成像（MRSI）和海马体积测量法在难治性癫痫患者中对内侧颞叶癫痫（MTLE）进行定侧的相对效用。
MTLE是接受颞叶癫痫手术患者中最常见的部分性发作性疾病。磁共振体积测量和波谱分析是用于MTLE定侧的可靠术前成像技术。
我们对30例连续接受颞叶切除术的患者术前的1H MRSI和海马结构体积进行了分析。
体积测量法在93%的患者中正确定出了手术侧，1H MRSI在97%的患者中做到了这一点。体积测量法在2例患者中定侧错误，1H MRSI在1例患者中定侧错误。所有磁共振成像方式之间的一致性为73%。Pearson分析显示海马体积丢失程度与肌酸与N-乙酰化化合物比值之间无相关性。
体积测量法和1H MRSI能正确定出大多数MTLE患者的病变侧，且在最终定侧中相互补充。体积丢失严重程度与代谢紊乱程度之间缺乏相关性，这表明这些技术检测的是MTLE中不同的病理生理过程。
