Subcortical and cerebellar atrophy in mesial temporal lobe epilepsy revealed by automatic segmentation
Subcortical and cerebellar atrophy in mesial temporal lobe epilepsy revealed by automatic segmentation
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DOI：
10.1016/j.eplepsyres.2008.01.006
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发表时间：
2008-05-01
影响因子：
2.2
通讯作者：
Halgren, Eric
中科院分区：
文献类型：
--
作者：
McDonald, Carrie R.;Hagler, Donald J., Jr.;Halgren, Eric
目的：确定使用自动皮质下分割来识别内侧颞叶癫痫（MTLE）患者海马体以及其他皮质下和小脑结构萎缩的有效性和实用性。
方法：对21例MTLE患者（11例右侧，10例左侧）和21例年龄及性别匹配的健康对照者进行体积磁共振成像（MRI）检查。使用自动重建软件（FreeSurfer）对皮质下和小脑结构进行标记。采用协方差多元分析（MANCOVA）来探究颅内标准化、年龄调整后的体积以及结构不对称性方面的组间差异。采用逐步判别函数分析来确定能优化个体受试者分类的体积线性组合。
结果：结果显示，在癫痫病灶同侧的海马体体积如预期般减小，丘脑和小脑灰质体积双侧减小。对结构不对称性的分析显示，与对照组相比，患者的海马体和壳核存在显著不对称。判别函数分析表明，使用包括左右海马体和左侧丘脑在内的皮质下体积组合，可最好地区分左右MTLE患者（使用交叉验证，正确分类率为91 - 100%）。
讨论：通过对皮质下和小脑结构自动分割获得的体积数据与先前基于手动描绘的研究数据相近。我们的数据表明，自动分割可为评估MTLE患者结构损伤的性质和程度提供一种临床上有用的方法，并可能提高患者的诊断分类，尤其是在海马体萎缩较轻时。（c）2008爱思唯尔有限公司。保留所有权利。
Purpose: To determine the validity and utility of using automated subcortical segmentation to identify atrophy of the hippocampus and other subcortical and cerebellar structures in patients with mesial temporal lobe epilepsy (MTLE).Methods: Votumetric MRIs were obtained on 21 patients with MTLE (11 right, 10 left) and 21 age- and gender-matched healthy controls. Labeling of subcortical and cerebellar structures was accomplished using automated reconstruction software (FreeSurfer). Multivariate analysis of covariance (MANCOVA) was used to explore group differences in intracranial-normalized, age-adjusted volumes and structural asymmetries. Step-wise discriminant function analysis was used to identify the linear combination of volumes that optimized classification of individual subjects.Results: Results revealed the expected reduction in hippocampal volume on the side ipsilateral to the seizure focus, as well as bilateral reductions in thalamic and cerebellar gray matter volume. Analysis of structural asymmetries revealed significant asymmetry in the hippocampus and putamen in patients compared to controls. The discriminant function analysis revealed that patients with right and left MTLE were best distinguished from one another using a combination of subcortical volumes that included the right and left hippocampus and left thalamus (91-100% correct classification using cross-validation).Discussion: Volumetric data obtained with automated segmentation of subcortical and cerebellar structures approximate data from previous studies based on manual tracings. Our data suggest that automated segmentation can provide a clinically useful means of evaluating the nature and extent of structural damage in patients with MTLE and may increase diagnostic classification of patients, especially when hippocampal atrophy is mild. (c) 2008 Elsevier B.V. All rights reserved.