氢质子磁共振波谱在原发性癫癎中的应用研究

邵晓丽; 周忠蜀; 洪闻

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中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (06) : 425-428.

论著·临床研究

氢质子磁共振波谱在原发性癫癎中的应用研究

邵晓丽，周忠蜀，洪闻

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Clinical application of proton magnetic resonance spectroscopy in children with idiopathic epilepsy

SHAO Xiao-Li, ZHOU Zhong-Shu, HONG Wen

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摘要

目的：应用氢质子磁共振波谱(proton magnetic resonance spectroscopy, 'H-MRS)检测癫癎患儿的脑组织生化代谢物，探讨'H-MRS在原发性癫癎中的临床应用价值及意义。方法：对33例原发性癫癎患儿（癫癎组，其中14例有热性惊厥史）和6例正常儿童（对照组）进行常规头颅MRI和颞叶海马区的'H-MRS检查。检测N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)和乳酸(Lac)的信号强度，计算并比较NAA/（Cho+Cr）和Lac/Cr的比值。结果：头颅MRI检查：除1例癫癎患儿表现为髓鞘发育不良外其余所有研究对象均无异常。'H-MRS检测：NAA/（Cho+Cr）比值在癫癎组为0.64±0.07,低于对照组(0.73±0.05)（P＜0.01）；同时伴有热性惊厥史的癫癎患儿为0.61±0.07，低于不伴有热性惊厥史的癫癎患儿（0.66±0.06）（P＜0.05）。癫癎组Lac/Cr比值与对照组差异无统计学意义。结论：'H-MRS作为一项无创的检查，能更敏感地发现癫癎患儿的早期脑损伤，为癫癎的诊断和评估预后提供客观依据。［中国当代儿科杂志，2010，12（6）：425-428］

Abstract

OBJECTIVE: This study examined the biochemical metabolism by proton magnetic resonance spectroscopy ('H-MRS) in order to explore the value of 'H-MRS in idiopathic epilepsy in children. METHODS: Thirty-three children with idiopathic epilepsy (14 cases with history of febrile seizures and 19 cases without) and six normal controls experienced MRI of the skull and brain and single-voxel 'H-MRS examinations of the hippocampi-temporal lobe. The signal intensities of N-acetylaspartate (NAA), eatine+phosphocreatine (Cr), choline-containig compounds (Cho) and lactate (Lac) and the ratios of NAA/ (Cho+Cr) and Lac/Cr were compared between the patients and normal controls. RESULTS: MRI examination showed that only one child with epilepsy had myelin dysplasia. 'H-MRS examination showed that the ratio of NAA/ (Cho+Cr) in the epilepsy group was lower than that in the control group (0.64±0.07 vs 0.73±0.05; P＜0.01). The epileptic children with history of febrile seizures had a more decreased ratio of NAA/ (Cho+Cr) compared with those without the history (0.61±0.07 vs 0.66±0.06; P<0.05). There were no significant differences in the ratio of Lac/Cr between the epilepsy and the control groups. CONCLUSIONS: 'H-MRS may provide early information on brain injury sensitively and non-invasively in children with epilepsy. It may be used for diagnosis and prognosis evaluation of epilepsy.［Chin J Contemp Pediatr, 2010, 12 (6):425-428］

导出引用

邵晓丽, 周忠蜀, 洪闻. 氢质子磁共振波谱在原发性癫癎中的应用研究[J]. 中国当代儿科杂志. 2010, 12(06): 425-428

SHAO Xiao-Li, ZHOU Zhong-Shu, HONG Wen. Clinical application of proton magnetic resonance spectroscopy in children with idiopathic epilepsy[J]. Chinese Journal of Contemporary Pediatrics. 2010, 12(06): 425-428

中图分类号： R748

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