CAJ | 학술논문

目的：探讨内侧颞叶癫痫患者中海马硬化的比例及影像学特点。方法选择2012年2月到2013年12月期间本院收治的78例内侧颞叶癫痫患者，采取磁共振成像（magnetic resonance imaging，MRI）测量海马体积，结合目测法进行海马硬化的判定，采取磁共振波谱（magnetic resonance spectroscopy, MRS）分析NAA (N-乙酰天门冬氨酸)浓度与（Cr±Cho）(肌酸±胆碱)的比值，与健康对照人群和非内侧颞叶癫痫患者进行比较。结果内侧颞叶癫痫组海马硬化的比例为58.97%，显著高于健康对照组和非颞叶内侧起源的癫痫组。内侧颞叶癫痫组的平均海马体积（2305.68±814.61 mm3、2456.71±743.60 mm3）同样较两组明显缩小。MRI上74.55%的内侧颞叶癫痫海马硬化表现为海马萎缩和T2WI信号增高。其海马硬化以左侧为多见（52.17%），有时可出现双侧海马硬化（19.57%）。MRS测定表明硬化的海马NAA/（Cr±Cho）显著降低（0.58±0.19）。结论海马硬化可能是内侧颞叶癫痫的主要影像学特点，其中海马萎缩和T2WI信号增高具有普遍性和特征性。
목적：탐토내측섭협전간환자중해마경화적비례급영상학특점。방법선택2012년2월도2013년12월기간본원수치적78례내측섭협전간환자，채취자공진성상（magnetic resonance imaging，MRI）측량해마체적，결합목측법진행해마경화적판정，채취자공진파보（magnetic resonance spectroscopy, MRS）분석NAA (N-을선천문동안산)농도여（Cr±Cho）(기산±담감)적비치，여건강대조인군화비내측섭협전간환자진행비교。결과내측섭협전간조해마경화적비례위58.97%，현저고우건강대조조화비섭협내측기원적전간조。내측섭협전간조적평균해마체적（2305.68±814.61 mm3、2456.71±743.60 mm3）동양교량조명현축소。MRI상74.55%적내측섭협전간해마경화표현위해마위축화T2WI신호증고。기해마경화이좌측위다견（52.17%），유시가출현쌍측해마경화（19.57%）。MRS측정표명경화적해마NAA/（Cr±Cho）현저강저（0.58±0.19）。결론해마경화가능시내측섭협전간적주요영상학특점，기중해마위축화T2WI신호증고구유보편성화특정성。
Objective To explore the incidence and imageological features of patients with the hippocampal sclerosis-associated medial temporal lobe epilepsy. Methods Seventy-eight patients with the medial temporal lobe epi?lepsy were recruited from our hospital during February 2012 to December 2013. Magnetic resonance imaging (MRI) and resonance spectroscopy (MRS) analysis were conducted in patients with with the hippocampal sclerosis-associated medial temporal lobe epilepsy, patients with epilepsy without the medial temporal lobe diseases and healthy controls. Results The incidence of hippocampal sclerosis was 58.97%among patients with medial temporal lobe epilepsy which were significantly higher compared with either healthy control group or patients with epilepsy without the medial tempo?ral lobe diseases. The average hippocampal volume of the medial temporal lobe epilepsy group(2305.68±814.61 mm3、2456.71±743. 60 mm3)was significantly smaller compared with either healthy controls or patients with epilepsy without the medial temporal lobe diseases. MRI revealed increased T2WI signal and hippocampal atrophy in 74.55%of patients with hippocampal sclerosis-associated medial temporal lobe epilepsy. Sclerosis was detected on the left side (52.17%) and bilateral hippocampus (19.57%). MRS showed that NAA/(Cr ± Cho) significantly reduced (0.58± 0.19) in the hip?pocampal sclerosis. Conclusions Hippocampal sclerosis may be the main imaging features of the medial temporal lobe epilepsy which are characterized by the hippocampal atrophy and high T2WI signal.