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題 名 | Proton Chemical Shift Imaging of the Hippocampus in Patients with Complex Partial Seizures=複雜性局部癲癇病人海馬迴之質子化學位移造影 |
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作 者 | 許元昱; 張承能; 朱迺欣; 張程; 徐至清; 林坤榮; | 書刊名 | 長庚醫學 |
卷 期 | 22:1 1999.03[民88.03] |
頁 次 | 頁68-75 |
分類號 | 415.932 |
關鍵詞 | 化學位移造影; 磁振頻譜; 複雜性局部癲癇; 海馬迴; Chemical shift imaging; Magnetic resonance spectroscopy; Complex partial seizure; Hippocampus; |
語 文 | 英文(English) |
中文摘要 | 背景:質子磁振頻譜(magnetic resonance spectroscopy)可以用來測量人體腦 部的代謝物質,例如 N-- 乙醯天門冬胺酸鹽( NAA ), 含膽鹼的化合物( Cho ),以及 肌胺酸 -- 磷肌胺酸( Cr )等。 在複雜性局部癲�部] complex partial seizure )患者 的海馬迴( hippocampus )內,曾有報告發現 NAA 降低,而 Cho 和 Cr 升高的情形。 方法:利用質子化學位移造影(chemical shift imaging),研究10位複雜性局部癲�陰w者 ,以及當做對照組的 12 位正常成年人的海馬迴。計算 NAA 與( Cho + Cr )的比值,進 行比較分析。 結果:與對照組比較,可以發現複雜性局部癲�陰w者的 NAA ╱( Cho + Cr )值顯著降低 :前半部海馬迴降低了 24 %( p = 0.001 ), 而後半部海馬迴則降低了 18 %( p = 0.002 )。 在這 10 位患者當中,有 4 位的磁振影像是正常,3 位的腦波檢查是正常,但 是質子化學位移造影都可檢測出單側或雙側的海馬迴異常。 在 6 位磁振影像異常的患者當 中,質子化學位移造影對於癲�陳f灶的定位,都與磁振影像的結果一致。 結論:質子化學位移造影比磁振造影和腦波檢查,更可及早測出癲�陰w者海馬迴內的代謝異 常;但必須進一步和手術結果配合比較,才能確定其定位癲�陳f灶的準確性。 |
英文摘要 | Background: Cerebral metabolites can be evaluated non-invasively using in vivo proton magnetic resonance spectroscopy (MRS) . Decreased N-acetylaspartate (NAA) and increased choline-containing compounds (Cho) and creatine-phosphocreatine (Cr) have been found in the hippocampus of patients with complex partial seizures (CPS). Methods: We prospectively studied hippocampal proton MRS of 10 patients with CPS and 12 control subjects by using the chemical shift imaging (CSI) technique. The spectral data were analyzed in terms of the ratio between the integral peak area of NAA and that of (Cho+Cr). Results: Compared with the control group, patients with CPS showed a significantly lower NAA/(Cho+Cr) ratio, both in the anterior and posterior hippocampus (p value= 0.001 and 0.002, respectively). Metabolic abnormalities of the hippocampus were detected using proton CSI in all the patients with normal MRI results (4 patients) and those with normal EEG results (3 patients). Lateralizations using proton CSI were obtained in all the 10 patients in this study, including concordant lateralization in the 6 patients with MRI-detectable abnormalities. Conclusion: The hippocampal abnormalities in patients with CPS can be detected early using proton CSI than using MRI or surface EEG. Lateralization of the seizure focus using proton CSI is possible, but further correlation with the surgical outcome in a larger study group is necessary. |
本系統中英文摘要資訊取自各篇刊載內容。