1H AND 31P MRSI FOR EPILEPSY LOCALIZATION

用于癫痫定位的 1H 和 31P MRSI

• 批准号: 6617286
• 负责人: KENNETH D LAXER
• 金额: $ 26.93万
• 依托单位: CALIFORNIA PACIFIC MED CTR RES INSTITUTE
• 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 2004-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6617286
• 关键词: bioimaging /biomedical imaging; brain disorder diagnosis; child (0-11); clinical research; diagnosis quality /standard; disease /disorder classification; electroencephalography; human subject; magnetic resonance imaging; neocortex; outcomes research; partial seizure; positron emission tomography; postoperative state; prognosis; telemetry; temporal lobe /cortex disorder; videotape /videodisc

The long term goal of this application is to improve the outcome of seizure surgery by better presurgical localization of medically refractory epilepsy using a combination of neuroimaging techniques including magnetic resonance imaging (MRI), 1H and 31P MR spectroscopic imaging (MRSI), and 18F-PET. These techniques will be directed at three groups with medically refractory epilepsy who are being evaluated for seizure surgery (numbers for 5 years): 1)patients with medial temporal lobe epilepsy in whom MRI is non-concordant i.e., MRI shows no abnormality, or an abnormality contralateral to the EEG-defined seizure focus (NC-mTLE, n=75), 2) patients with non-lesional neocortical epilepsy (NE, n=100), and 3) children with Infantile Spasms (IS, n=100). NC-mTLE and NE patients frequently require invasive EEG recording, have less than a 50 percent probability of becoming seizure free with surgery, and are often not considered for surgery. Post-operative surgical outcome will be analyzed in relation to the pre-operative neuroimaging findings. Hypotheses: 1) NC-mTLE -Patients with medically refractory mTLE without MRI concordance, who have 1H and 31P MRSI measures concordant with the EEG localization (i.e., lobe and side), will have a significantly better post surgical outcome than patients without MRSI concordance. 2a) NE - NE patients without lesions on MRI, will have 1H and 31P MRSI concordant with the EEG localization (i.e., lobe and side), and this concordance will be greater than that provided by 18FDG-PET. 2b) NE - NE patients, who have 1H and 31P MRSI measures concordant with the EEG localization will have a significantly better post surgical outcome than patients without MRSI concordance. 3a) IS - Children with medically refractory Infantile Spasms will have 1H and 31P MRSI concordant with the seizure focus determined by a combination of two or more studies (VET, 18FDG-PET, and/or MRI) and this concordance will be greater than that provided by MRI or 18FDG-PET. 3b) IS - IS children, who have 1H and 31P MRSI concordant with the localization provided by the other clinical and imaging studies will have a significantly better post surgical outcome than patients without such concordance. These studies are expected to lead to improved surgical outcome, and to reduce unnecessary surgery, in patients with intractable epilepsy.

该应用的长期目标是结合使用包括磁共振成像 (MRI)、1H 和 31P MR 光谱成像 (MRSI) 和 18F-PET 在内的神经影像技术，对医学难治性癫痫进行更好的术前定位，从而改善癫痫手术的结果。 这些技术将针对正在接受癫痫手术评估的三组患有医学难治性癫痫的患者（数量为 5 年）：1）MRI 不一致的内侧颞叶癫痫患者，即 MRI 显示无异常，或 EEG 定义的癫痫病灶对侧有异常（NC-mTLE，n = 75），2）患有内侧颞叶癫痫的患者 非病变性新皮质癫痫（NE，n=100），3）患有婴儿痉挛症的儿童（IS，n=100）。 NC-mTLE 和 NE 患者经常需要侵入性脑电图记录，通过手术消除癫痫发作的可能性不到 50%，并且通常不考虑进行手术。 将根据术前神经影像学结果来分析术后手术结果。 假设：1) NC-mTLE - 具有医学难治性 mTLE 且无 MRI 一致性的患者，其 1H 和 31P MRSI 测量与 EEG 定位（即叶和侧）一致，将比没有 MRSI 一致性的患者获得明显更好的术后结果。 2a) MRI 上没有病变的 NE - NE 患者将具有与 EEG 定位（即叶和侧）一致的 1H 和 31P MRSI，并且这种一致性将大于 18FDG-PET 提供的一致性。 2b) 具有与 EEG 定位一致的 1H 和 31P MRSI 测量的 NE - NE 患者将比没有 MRSI 一致性的患者具有明显更好的术后结果。 3a) IS - 患有难治性婴儿痉挛症的儿童的 1H 和 31P MRSI 与通过两项或多项研究（VET、18FDG-PET 和/或 MRI）组合确定的癫痫病灶一致，并且这种一致性将大于 MRI 或 18FDG-PET 提供的一致性。 3b) IS - IS 儿童，其 1H 和 31P MRSI 与其他临床和影像学研究提供的定位一致，将比没有这种一致性的患者获得明显更好的术后结果。 这些研究预计将改善顽固性癫痫患者的手术结果，并减少不必要的手术。