1H AND 31P MRSI FOR EPILEPSY LOCALIZATION

用于癫痫定位的 1H 和 31P MRSI

• 批准号: 2269937
• 负责人: KENNETH D LAXER
• 金额: $ 20.87万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-05-01 至 1998-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2269937
• 关键词: brain disorder diagnosis; diagnosis quality /standard; disease /disorder classification; electroencephalography; epilepsy; longitudinal human study; magnetic resonance imaging; neocortex; positron emission tomography; prognosis; surgery; telemetry; temporal lobe /cortex disorder; videotape /videodisc

The overall long-term goal of this project is to improve the outcome of seizure surgery by the development of improved methods for the localization of seizure foci. It has clearly been demonstrated that when there is concordance between video/EEF telemetry (VET) and PET, or MRI, patients have an improved prognosis for seizure relief by seizure surgery compared to discordant studies. Unfortunately, approximately 50% of the patients with temporal lobe epilepsy (TLE), and 70% of the patients with neocortical epilepsy (NE) do not have concordant imaging studies. Preliminary studies utilizing MRS have demonstrated metabolic abnormalities in the epileptogenic zone with the focus defined by increased Pi and pH, and decreased NAA and PME. These preliminary studies have also demonstrated that these changes can be used to accurately predict the side of seizure onset (lateralization) with sensitivity in TLE as good as or better than PET. The goal of this application is to develop the combination of diagnostic measures which best predicts surgical outcome. To achieve this goal VET and the three imaging modalities employed in this study (PET, MRI, and MRSI) will be used to provide classification information. We will develop decision rules to determine which measures (e.g. VET, pH, Pi, PME, NAA, atrophy, increased signal intensity, hypometabolism) or combination of measures best predicts surgical outcome. It is expected that: 1) MRSI will provide better concordance with VET than MRI, or PET for TLE, 2) the best surgical outcome will be associated with the highest concordance between all modalities, 3) the abnormalities defined for the epileptogenic focus in TLE will also be true for NE. In conclusion, these results should lead to more effective preoperative evaluation for seizure surgery, providing a greatly improved diagnostic approach for evaluation of TLE & NE.

该项目的总体长期目标是改善 癫痫手术的改进方法的发展， 癫痫灶的定位。 事实证明，当 视频/EEF遥测（VET）和PET或MRI之间存在一致性， 通过癫痫发作手术，患者的癫痫发作缓解预后得到改善 与不一致的研究相比。 不幸的是，大约50%的 颞叶癫痫（TLE）患者，70%的患者 新皮质癫痫（NE）没有一致的成像研究。 利用MRS的初步研究表明， 致痫区异常，病灶定义为 提高了Pi和pH值，降低了NAA和PME。 这些初步 研究还表明，这些变化可以用于 准确预测癫痫发作的一侧（偏侧）， TLE的灵敏度与PET一样好或更好。 这个目标 应用是开发诊断措施的组合， 最能预测手术结果。 为了实现这一目标， 本研究中使用的成像方式（PET、MRI和MRSI）将 用于提供分类信息。 我们将做出决定 规则，以确定哪些措施（如VET，pH值，Pi，PME，NAA，萎缩， 增加的信号强度、低代谢）或测量的组合 最能预测手术结果。 预计：1）MRSI将 与MRI或PET相比，TLE与VET的一致性更好，2）最佳 手术结果将与以下因素之间的最高一致性相关： 所有模态，3）癫痫病灶定义的异常 在TLE中，对于NE也是如此。 总之，这些结果应导致更有效的术前 评估癫痫手术，提供了一个大大改善的诊断 评价TLE和NE的方法。