Temporal lobe epilepsy: Bilateral hippocampal metabolite changes revealed at proton MR spectroscopic imaging
Temporal lobe epilepsy: Bilateral hippocampal metabolite changes revealed at proton MR spectroscopic imaging
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DOI：
10.1148/radiology.202.3.9051038
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发表时间：
1997-03-01
期刊：
影响因子：
19.7
通讯作者：
Weiner, MW
中科院分区：
文献类型：
--
作者：
Ende, GR;Laxer, KD;Weiner, MW
目得：为了确定哪种质子磁共振（MR）波谱成像方法最适合于在MR图像上对颞叶癫痫伴和不伴海马萎缩的患者的癫痫病灶定侧、对侧异常的程度以及MR波谱成像结果与手术结果之间是否存在相关性。材料和方法：对16例单侧脑电图表现为颞叶癫痫的成人患者和16例对照组进行了磁共振波谱成像。结果：9例患者在MRI上表现为海马萎缩。在所有患者中均发现同侧N-乙酰天冬氨酸浓度或N-乙酰天冬氨酸与肌酸和胆碱之和的比率（N-乙酰天冬氨酸/[肌酸+胆碱]）降低。在8例患者（50%）中检测到对侧N-乙酰天门冬氨酸浓度N-乙酰天门冬氨酸/（肌酸+胆碱）或N-乙酰天门冬氨酸浓度和N-乙酰天门冬氨酸/（肌酸+胆碱）降低，这表明MR成像未检测到双侧异常。在5例接受手术并且在MR图像上没有显示海马萎缩的患者中，成功和不成功的结局可以用N-乙酰天冬氨酸浓度正确预测。结论：N-乙酰天冬氨酸浓度降低不仅仅是由于海马萎缩。外侧异常比预期的更常见。磁共振波谱成像对癫痫的术前评估有重要价值。
PURPOSE: To determine which proton magnetic resonance (MR) spectroscopic imaging measures are best for lateralizing the seizure focus in patients who have temporal lobe epilepsy with and in those without hippocampal atrophy on MR images, the extent of contralateral abnormalities, and whether there is a correlation between MR spectroscopic imaging findings and surgical outcome.MATERIALS AND METHODS: MR spectroscopic imaging was performed in 16 adult patients with temporal lobe epilepsy and unilateral electroencephalographic findings and in 16 adult control subjects. Eleven patients underwent surgery; all patients underwent MR imaging.RESULTS: Nine patients had hippocampal atrophy on MR images. An ipsilateral decrease in the N-acetylaspartate concentration or the ratio of N-acetylaspartate to the sum of creatine and choline (N-acetylaspartate/[creatine + choline]) was found in all patients. Decreased contralateral N-acetylaspartate concentration N-acetylaspartatel/(creatine + choline), or N-acetylaspartate concentration and N-acetylaspartate/(creatine + choline) were detected in eight patients (50%), which suggests bilateral abnormalities not detected with MR imaging. In the five patients who underwent surgery and did not show hippocampal atrophy on MR images, successful and unsuccessful outcomes were correctly predicted with N-acetylaspartate concentrationCONCLUSION: Decreased N-acetylaspartate concentration is not due solely to hippocampal atrophy. Contralateral abnormalities are much more frequent than expected. MR spectroscopic imaging is valuable in the presurgical evaluation of epilepsy.