CAJ | 학술논문

目的观察室管膜下型灰质异位(PNH)所发出白质纤维束的空间分布形式以及与正常脑组织的空间位置关系.方法8例以癫痫症状就诊的PNH患者经3.0T磁共振仪T1及T2加权成像诊断,并采集弥散张量成像数据.采用白质纤维束追踪技术,以异位灰质团块作为种子点,对异位灰质相连的白质纤维束进行描绘,并观察总结其空间分布模式及与其他大脑结构之间的关系.结果异位灰质白质纤维束有以下分布特点:①异位灰质均能发出自身的白质纤维,其中有4例表现为仅与位于同侧大脑半球的长联络纤维连接;3例除联络纤维外,还可见到其白质纤维参与对侧的胼胝体连接;6例可见到连接至皮层的弓状纤维;②结构连接空间模式与灰质异位所处位置有关,位于侧脑室前角旁的异位灰质发出的联络纤维主要分布于前方,位于侧脑室后角旁的异位灰质发出的联络纤维主要分布于后方,靠近胼胝体的异位灰质其白质纤维较易连接到对侧,靠近皮层的异位灰质较易发出弓状纤维与皮层相连.结论异位灰质不是孤立的结构,其可发出或长或短的白质纤维,并较广泛地与正常脑结构保持连接;其纤维连接分布的空间模式与异位灰质所处的位置有关.
목적관찰실관막하형회질이위(PNH)소발출백질섬유속적공간분포형식이급여정상뇌조직적공간위치관계.방법8례이전간증상취진적PNH환자경3.0T자공진의T1급T2가권성상진단,병채집미산장량성상수거.채용백질섬유속추종기술,이이위회질단괴작위충자점,대이위회질상련적백질섬유속진행묘회,병관찰총결기공간분포모식급여기타대뇌결구지간적관계.결과이위회질백질섬유속유이하분포특점:①이위회질균능발출자신적백질섬유,기중유4례표현위부여위우동측대뇌반구적장련락섬유련접;3례제련락섬유외,환가견도기백질섬유삼여대측적변지체련접;6례가견도련접지피층적궁상섬유;②결구련접공간모식여회질이위소처위치유관,위우측뇌실전각방적이위회질발출적련락섬유주요분포우전방,위우측뇌실후각방적이위회질발출적련락섬유주요분포우후방,고근변지체적이위회질기백질섬유교역련접도대측,고근피층적이위회질교역발출궁상섬유여피층상련.결론이위회질불시고립적결구,기가발출혹장혹단적백질섬유,병교엄범지여정상뇌결구보지련접;기섬유련접분포적공간모식여이위회질소처적위치유관.
Objective To explore the spatial patterns of white matter fibres sprung from heterotopic nodules and the white mater connection between nodules and the normal cortical regions in periventricular nodular heterotopia (PNH) patients with epilepsy. Methods The data of three-dimensional MRI and diffusion tensor imaging (DTI) of PNH were obtained by 3T MR scanners in 8 patients with epilepsy. The heterotopic nodules were adopted as regions of interest (ROIs), which were calculated as seeds in displaying the distributions of white mater fibres. Results DTI revealed that there were the fibres originated from all the heterotopic nodules, which extended to adjacent white matters or even the cortexes, but the lengths and destinations of the fibres were variable in the patients. The fibres were only acting as association fibres in the same side cerebral hemisphere in 4 patients. The fibres from the unilateral-nodules crossed corpus callosum to the contralateral cerebral hemisphere in 3 patients. The fibres were found to serve as arciform fibres in 6 patients. The spatial patterns of the fibres were associated with the nodular position. The heterotopic nodules located along the antecornu were more likely to generate the fibres towards the anterior cerebral regions, while the ones along the cornu occipital were more likely to generate the fibres towards posterior cerebral regions and the ones originated from the nodules closed to the corpus callosum extended to the contralateral cerebrum. Conclusions The present results suggested that the heterotopic nodules are not self-existent and they are connected with adjacent white matters or the distant cortexes by white matter fibres. It might be the structural basis of functional connection between the heterotopic nodule and the other cerebral regions in the patients with epilepsy. The fibres may be involved in the epileptic network.