CAJ | 학술논문

【目的】基于像素的形态学测量（VBM ）法分析颞叶癫痫患者脑区灰质密度和体积的差异，探讨VBM对常规M RI未发现病灶的颞叶癫痫患者的检测准确性。【方法】选择本院收治的30例常规M RI未发现病灶的颞叶癫痫患者（颞叶癫痫组），其中男13例，女17例；选择同期本院体检健康者30例（对照组），其中男16例，女14例。采用磁化预备快速梯度回波序列进行高分辨率全脑结构像扫描两组研究对象脑部，通过VBM分析其全脑灰质体积及密度变化。【结果】①颞叶癫痫患者组的左侧枕叶、楔叶，右侧小脑山顶脑区的灰质密度较对照组降低，差异有显著性意义；双侧壳核、外侧苍白球、左侧颞下回、右侧额下回脑区的灰质密度较对照组升高，差异有显著性意义；②颞叶癫痫患者组双侧岛叶，右侧中央前回、颞上回、楔叶、楔前叶、枕中回、缘上回，左侧颞中回、角回、舌回、颞横回、中央后回、中央旁小叶、海马旁回、梭状回的脑灰质体积较正常对照组降低，差异有显著性；未发现灰质体积升高的脑区。【结论】颞叶癫痫患者不仅颞叶灰质存在异常，而且颞叶外脑区也存在广泛的灰质异常，对于常规M RI未发现病灶的颞叶癫痫患者，进行VBM 分析可发现广泛的脑结构异常。
【목적】기우상소적형태학측량（VBM ）법분석섭협전간환자뇌구회질밀도화체적적차이，탐토VBM대상규M RI미발현병조적섭협전간환자적검측준학성。【방법】선택본원수치적30례상규M RI미발현병조적섭협전간환자（섭협전간조），기중남13례，녀17례；선택동기본원체검건강자30례（대조조），기중남16례，녀14례。채용자화예비쾌속제도회파서렬진행고분변솔전뇌결구상소묘량조연구대상뇌부，통과VBM분석기전뇌회질체적급밀도변화。【결과】①섭협전간환자조적좌측침협、설협，우측소뇌산정뇌구적회질밀도교대조조강저，차이유현저성의의；쌍측각핵、외측창백구、좌측섭하회、우측액하회뇌구적회질밀도교대조조승고，차이유현저성의의；②섭협전간환자조쌍측도협，우측중앙전회、섭상회、설협、설전협、침중회、연상회，좌측섭중회、각회、설회、섭횡회、중앙후회、중앙방소협、해마방회、사상회적뇌회질체적교정상대조조강저，차이유현저성；미발현회질체적승고적뇌구。【결론】섭협전간환자불부섭협회질존재이상，이차섭협외뇌구야존재엄범적회질이상，대우상규M RI미발현병조적섭협전간환자，진행VBM 분석가발현엄범적뇌결구이상。
[Objective] To explore the changes of whole‐brain gray matter in temporal lobe epilepsy (TLE) .[Methods] A total of 42 TLE patients and 30 gender ,age and education‐matched healthy controls un‐derwent 3 .0T magnetic resonance imaging (MRI) scan and T1‐weighted 3D datasets were acquired .And vox‐el‐based morphometry (VBM ) was employed to define the differences in regional gray matter between controls and patients .[Results] Some data were excluded because of head movement .The data were analyzed finally for 30 patients (13 males/17 females) and 30 healthy controls (16 males/14 females) .Compared with healthy controls ,the TLE patients showed a significantly increased density of gray matter in left occipital lobe cuneus and right culmen and a significantly decreased density of gray matter in bilateral putamen ,lateral globus palli‐dus ,left inferior temporary gyrus and right inferior frontal gyrus .Compared with healthy controls ,the TLE patients showed a significantly decreased volume of gray matter in bilateral insula ,right precentral gyrus ,su‐perior temporal gyrus ,cuneus ,precuneus ,middle occipital gyrus ,supramarginal gyrus ,left middle temporal gyrus ,lingual gyrus ,angular gyrus ,transverse temporal gyrus ,posterior central gyrus ,paracentral gyrus , parahippocampa gyrus and fusiform gyrus .There was no region of significantly increased volume of gray mat‐ter .[Conclusion] In TLE ,gray matter abnormalities are not confined to temporal lobe but also extratemporal structures .And VBM may detect the extensive changes of brain structure in MRI‐negative epileptics .