中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2011年
1期
44-47
,共4页
杨岸超%张凯%娄平阳%乔慧%孟凡刚%刘焕光%陈宁%葛明%胡文瀚%张建国
楊岸超%張凱%婁平暘%喬慧%孟凡剛%劉煥光%陳寧%葛明%鬍文瀚%張建國
양안초%장개%루평양%교혜%맹범강%류환광%진저%갈명%호문한%장건국
癫痫%前颞叶叨除术%视放射%视野缺损%弥散张量成像
癲癇%前顳葉叨除術%視放射%視野缺損%瀰散張量成像
전간%전섭협도제술%시방사%시야결손%미산장량성상
Epilepsy%Anterior temporal lobectomy%Optic radiation%Visual field defect%Diffusion tensor imaging
目的 观察颞叶癫痫患者前颞叶切除术后视野缺损的发生率以及手术切除范围与视野缺损的关系.方法 25例前颞叶切除术的患者于术前及随访时行视野、磁共振(含DTI弥散张量序列)检查,根据视野缺损严重程度的不同将患者分为A、B、C三级.手术后视放射的各向异性分数(FA值)的下降(△FA)代表Meyer袢受损情况.比较不同视野缺损组之间前颞叶切除范围的差异;并对切除范围和△FA进行线性相关分析.结果 前颞叶切除术后22例患者出现象限盲.前颞叶平均切除长度:A组31.1 mm,B组42.5 mm,C组50.4 mm,A＜B＜C组(P＜0.05).手术侧的△FA与切除范围旱线性相关.结论 前颞叶切除术破坏视放射导致视野缺损较常见.有必要术前应用DTI获得患者视放射的信息,进行术前风险评估.
目的 觀察顳葉癲癇患者前顳葉切除術後視野缺損的髮生率以及手術切除範圍與視野缺損的關繫.方法 25例前顳葉切除術的患者于術前及隨訪時行視野、磁共振(含DTI瀰散張量序列)檢查,根據視野缺損嚴重程度的不同將患者分為A、B、C三級.手術後視放射的各嚮異性分數(FA值)的下降(△FA)代錶Meyer袢受損情況.比較不同視野缺損組之間前顳葉切除範圍的差異;併對切除範圍和△FA進行線性相關分析.結果 前顳葉切除術後22例患者齣現象限盲.前顳葉平均切除長度:A組31.1 mm,B組42.5 mm,C組50.4 mm,A＜B＜C組(P＜0.05).手術側的△FA與切除範圍旱線性相關.結論 前顳葉切除術破壞視放射導緻視野缺損較常見.有必要術前應用DTI穫得患者視放射的信息,進行術前風險評估.
목적 관찰섭협전간환자전섭협절제술후시야결손적발생솔이급수술절제범위여시야결손적관계.방법 25례전섭협절제술적환자우술전급수방시행시야、자공진(함DTI미산장량서렬)검사,근거시야결손엄중정도적불동장환자분위A、B、C삼급.수술후시방사적각향이성분수(FA치)적하강(△FA)대표Meyer번수손정황.비교불동시야결손조지간전섭협절제범위적차이;병대절제범위화△FA진행선성상관분석.결과 전섭협절제술후22례환자출현상한맹.전섭협평균절제장도:A조31.1 mm,B조42.5 mm,C조50.4 mm,A＜B＜C조(P＜0.05).수술측적△FA여절제범위한선성상관.결론 전섭협절제술파배시방사도치시야결손교상견.유필요술전응용DTI획득환자시방사적신식,진행술전풍험평고.
Objective Anterior temporal lobectomy(ATL) for temporal lobe epilepsy (TLE) is the most commonly performed epilepsy surgery procedure.A visual field defect(VFD) due to the injury to the optic radiation may occur after ATL.DTI technique can visualize the optic radiation (OR) noninvasively.This study aimed at evaluating the incidence of VFD after ATL and investigating whether the resection size of lateral ATL correlated with the extent of VFD.We tried to explain the impact of ATL on the OR and to investigate the anterior extending of Meyer loop with DTI technology.Method 25 patients( 14male, 11 female) underwent ATL for treatment of epilepsy.The patients were aged from 13 to 39 years old ( mean age:22.4 yrs).All cases were classified into three groups on the basis of the severity of VFD( A ～ C,with group C the most severe).All patients had preoperative and follow up clinical and MRI( including DTI series) examinations.The clinical and MRI(DTI) outcomes of these patients were retrospectively analyzed.Results At mean follow up period of 31.3 weeks ( range, 17 - 42 weeks), we found 22 patients become quadrantanopia due to the injury to OR after ATL.A significant reduction of fractional anisotropy was demonstrated in the OR on the side of the temporal lobectomy.The severity of VFD decreased according to the reducing of the mean resection size(group A, 31.1 mm;group B 42.5 mm;C, 50.4 mm), P ＜0.05.There was linearship between the resection size and the FA decrease.Conclusions VFD due to the injury to the OR was not uncommon after ATL There was an association between the resection size and severity of VFD.Optic radiation showed a decreased FA value in cases after ATL.There is considerable intersubjective variance about the OR, so it is necessary to get the patient's DTI information about the OR before the operation ,which could help to assess the preoperative risks.
