磁共振单体素波谱在颞叶癫痫诊断中的应用-影像医学与核医学专业论文.docxVIP

— — PAGE 1— 摘 要 磁共振单体素波谱在颞叶癫痫诊断中的应用 研究生：肖 红 导师：贾文霄 教授 摘 要 目的：评价单体素氢质子磁共振波谱(SVS)在诊断颞叶癫痫（TLE）脑组织生化 代谢物质检测的临床意义及定位诊断的应用价值。方法：颞叶癫痫患者24例，其中 15例经手术和病理证实，同时设24例健康志愿者做为对照组，常规行磁共振成像(MRI) 扫描除外肿瘤和血管畸形等脑部结构性病变。分别行双侧颞叶内侧氢质子(H1-MRS), 并在双侧海马区域进行精确定位,并计算峰下面积,对代谢产物N-乙酰天门冬氨酸 (NAA) 、 胆碱复合物 (Cho) 、 肌酸 (Cr) 的浓度进行相对的定量分析，并且计 算 NAA\(Cho+Cr)、NAA\Cr和NAA\Cho的比值,同时进行比较，同时行脑电图对致痫灶 进行定侧诊断。 结 果 ： TLE患侧组的乙酰天门冬氨酸/胆碱+肌 酸,[NAA/(CHO+Cr)](0.47±0.06)、乙酰天门冬氨酸/肌酸,NAA/Cr(0.93±0.22)下降, 与对侧组、对照组(分别为0.58±0.15、1.28±0.24;0.68±0.09、1.48±0.18)差值 有意义(P 0.05)。结论：svs是一种无创性探测脑组织内生化代谢物质的方法,癫 痫患者脑组中NAA信号强度下降,Cho及Cr信号强度升高,NAA\(Cho+Cr)比值下降, 提示神经元受损,胶质细胞的增生。H1-MRS能敏感地探测到神经元的异常改变，为颞 叶癫痫术前定位提供了一种新的检查方法,与MRI，脑电图相结合可提高术前定位的 准确率。 关键词：MRS；难治性癫痫;海马;癫痫病灶 新疆医科大学医学硕士学位论文 Diangnosis of temporal epilepsy with single-voxel hydrogen proton magnetic resonance spectroscopy Postgraduate: Xiao Hong Supervisor:Jia Wenxiao professor Abstract Objective：to analysis of (single-voxel hydrogen proton magnetic resonance spectro -scopy,SVS) in detecting biochemical metabolism inpatients with temporal epilepsy and localization diagnosis.Methods：in 24 cases of temporal epilepsy including 15 verified by operation and pathology and 24 healthy volunteers were studied ,tradional MRI scan were used to expel the tumor and vascular malformation of brain .H1-MRS were both obtained in the region of both temporal lobes,the both hippocampus regions were exactly localized. The values of N-acetylaspartate (NAA) ,Creatine (Cr) and Choline (Cho) were calculated by integration of their peaks ,and the relative ratios of NAA/(Cho+Cr), NAA\Cr,NAA\Cho were analyzed.,meanwhile to diagnose the leision. Result：The ipsilateral epletogenic leision of patients showed lower ratios of NAA/(Cho+Cr) andNAA/Cr, and the differences compared with those of the normal group and contralateral subgroup were statistically significant. Conclusion：SVS can provide biochemical and metabolic information on patients with TLE,the intensity of NAA and ratio of NAA\(Cho+Cr) were decreased by H1-