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目的初步探讨单体素短回波点分辨率空间选择序列(point-resolved spatial selection,PRESS)氢质子磁共振波谱(1H-MRS)在常规MRI阴性的青少年颞叶癫痫(TLE)患者定侧诊断中的应用。资料与方法对常规MRI检查阴性的27例TLE患者及10名与之年龄匹配的健康志愿者行海马区域1H-MRS扫描和测量,并以癫痫患者24h脑电图(EEG)为致癫痫灶的定位指标,通过测定N-乙酰天门冬氨酸(NAA)/胆碱+肌酸(Cho+Cr)、谷氨酸盐(Glx)、肌醇(mI)分析其对MRI阴性TLE的定侧价值。结果27例TLE患者均完成1H-MRS扫描,22例谱线基线稳定,信噪比较好;22例癫痫患者1H-MRS结果与正常对照组测值平均值比较均发现异常,其中15例定侧与EEG符合。结论单体素短回波1H-MRS(PRESS序列)可以发现常规MRI阴性的TLE患者海马区脑组织代谢的异常,并能较好地定侧,为临床诊断致癫痫灶提供帮助。
OBJECTIVE: To investigate the diagnostic value of 1H-MRS with point-resolved spatial selection (PRESS) in patients with conventional MRI-negative adolescent temporal lobe epilepsy (TLE) In the application. Materials and Methods 1H-MRS scans and measurements in hippocampus of 27 TLE patients and 10 age-matched healthy volunteers who had negative MRI examination were performed. Electroencephalogram (EEG) was used to detect epileptic foci in patients with epilepsy Positioning parameters were determined by determining NAA / Cho + Gln / mI in MRI-negative TLE . Results Totally 27 cases of TLE patients completed 1H-MRS scan, the baseline of 22 cases was stable and the signal-to-noise ratio was good. The 1H-MRS results of 22 cases of epilepsy were found abnormal compared with the average value of normal control group, of which 15 cases Side meets EEG. Conclusion 1H-MRS (PRESS sequence) of univariate short echo can find abnormalities of brain tissue metabolism in the hippocampus of patients with conventional MRI-negative TLE and can be better positioned to provide help for the clinical diagnosis of epileptic foci.