Postictal diffusion-weighted imaging for the localization of focal epileptic areas in temporal lobe epilepsy
Postictal diffusion-weighted imaging for the localization of focal epileptic areas in temporal lobe epilepsy
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DOI：
10.1046/j.1528-1157.2001.19500.x
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发表时间：
2001-01-01
期刊：
影响因子：
5.6
通讯作者：
Lüders, HO
中科院分区：
文献类型：
--
作者：
Diehl, B;Najm, I;Lüders, HO
目的：磁共振弥散加权成像(DWI)是一种新技术，可用于显示各种原因引起的细胞毒性水肿。我们假设DWI还可以在发作期和发作后早期发现致痫区域和邻近区域。方法：我们研究了9例顽固性TLE患者，7例由海马硬化引起的患者，1例左侧内侧颞叶肿瘤患者，1例原因不明的患者。在纳入研究之前，需要征得知情同意。所有单次短暂性发作的患者在EEG记录的癫痫发作后立即(45-150分钟)进行扫描；两名处于癫痫状态的患者中有一名在癫痫停止后14小时进行扫描。通过计算表观弥散系数(ADC)图对DWI结果进行可视化分析。结果：我们发现6例TLE患者中有1例由于HS和单次短时发作导致ADC显著降低。1例未完全切除的颞叶肿瘤患者也表现出ADC值异常。1例局灶性癫痫持续状态患者的ADC值降低，1例持续先兆的患者无DWI异常。结论：在某些TLE患者中，发作后的DWI技术偶尔有助于显示癫痫区域。HS和单次短暂性癫痫发作患者的收益率较低：可能更高。在肿瘤或癫痫持续状态的患者中。
Purpose: Diffusion-weighted MR imaging (DWI) is a novel technique to delineate focal areas of cytotoxic edema of various etiologies. We hypothesized that DWI may also detect the epileptogenic region and adjacent areas during the ictal and early postictal periods in patients with temporal lobe epilepsy (TLE).Methods: We studied patients with intractable TLE (n = 9), due to hippocampal sclerosis (HS, n = 7), left mesial temporal lobe tumor (n = 1), and of unknown etiology (n = 1). Informed consent was obtained before inclusion in the study. All patients with single short seizures were scanned immediately after EEG-documented seizures (between 45 and 150 min); one of two patients in status was scanned 14 h after cessation of seizures. DWI results were analyzed visually and by calculating apparent diffusion coefficient (ADC) maps.Results: We found significant decreases in ADC postictally in one of six patients with TLE due to HS and single short seizures. One patient with an incompletely resected temporal lobe tumor also exhibited ADC abnormalities. One patient in focal status epilepticus revealed a decrease in ADC, and one patient with a continuous aura had no DWI abnormality.Conclusions; Postictal DWI technique may occasionally help delineate epileptic areas in some patients with TLE. Yield is low in patients with HS and single short seizures: it may be higher. in patients with tumor or status epilepticus.