CAJ | 학술논문

目的探讨海马氢质子磁共振波谱分析(1H-MRS)在颞叶癫痫症中的应用价值。方法采用Philips Achieva 1.5 T双梯度磁共振扫描仪，对38例颞叶癫痫患者和20例健康志愿者行颅脑MRI和海马1H-MRS检查，观察NAA、Cr、Cho浓度和NAA/(Cho+Cr)、NAA/Cr和NAA/Cho值。分别对癫痫患者病灶侧与正常侧，病灶侧与正常对照组海马的NAA/(Cho+Cr)、NAA/Cr和NAA/Cho值进行t检验，分析两者之间差异有无显著性。结果癫痫患者组癫痫侧、正常侧和对照组海马的NAA/(Cho+Cr)值分别为(0.42±0.06)、(0.67±0.09)、(0.72±0.07),癫痫组癫痫侧与正常侧、对照组比较差异有显著性（P＜0.05），而正常侧与对照组比较差异无显著性(P＞0.05)。以NAA/(Cho+Cr)来检出癫痫，灵敏度曲线呈现低→高→低的变化，在0.60时，灵敏度最高。结论 1H-MRS不仅能早期诊断海马硬化，而且可进一步提高术前癫痫灶定位的准确性。
목적 탐토해마경질자자공진파보분석(1H-MRS)재섭협전간증중적응용개치。방법 채용Philips Achieva 1.5 T쌍제도자공진소묘의，대38례섭협전간환자화20례건강지원자행로뇌MRI화해마1H-MRS검사，관찰NAA、Cr、Cho농도화NAA/(Cho+Cr)、NAA/Cr화NAA/Cho치。분별대전간환자병조측여정상측，병조측여정상대조조해마적NAA/(Cho+Cr)、NAA/Cr화NAA/Cho치진행t검험，분석량자지간차이유무현저성。결과 전간환자조전간측、정상측화대조조해마적NAA/(Cho+Cr)치분별위(0.42±0.06)、(0.67±0.09)、(0.72±0.07),전간조전간측여정상측、대조조비교차이유현저성（P＜0.05），이정상측여대조조비교차이무현저성(P＞0.05)。이NAA/(Cho+Cr)래검출전간，령민도곡선정현저→고→저적변화，재0.60시，령민도최고。결론 1H-MRS불부능조기진단해마경화，이차가진일보제고술전전간조정위적준학성。
Objective To study the application value of hippocampus proton magnetic resonance spectroscopy (1H-MRS) in temporal lobe epilepsy. Methods With Philips Achieva 1.5T dual gradient MR scanner, 38 patients with temporal lobe epilepsy and 20 healthy volunteers were underwent brain MRI and hippocampal 1H-MRS examination, observation indicators included the concentration of NAA, Cr, Cho and the value of NAA/(Cho+Cr), NAA/Cr and NAA/Cho. The NAA/(Cho+Cr), NAA.Cr and NAA/Cho values in hippocampus of epilepsy side of epilepsy group, the normal side of epilepsy group, and the normal control group had a t test, analyzing the statistical difference between the two groups.Results The NAA/(Cho+Cr) values in hippocampal of the epilepsy side of epileptic patients, the normal side of epileptic patients and the control group were (0.42+0.06), (0.67+0.09), (0.72+0.07), respectively, there was significant difference between the epilepsy side and the normal side of epileptic patients, and between the epilepsy side of epileptic patients and the control group(P＜0.05), but no significant difference between the normal side of epileptic patients and the control group(P＞0.05). Using NAA/(Cho+Cr) to detect epilepsy, the sensitivity curve showed low→high→low changes, the highest sensitivity appeared in 0.60.Conclusion 1H-MRS not only has early diagnosis to hippocampal sclerosis, but also improves the accuracy of preoperative localization of epileptic focus.