【作者】 刘雅婧；

【导师】 陈阳美；

【作者基本信息】 重庆医科大学 ， 神经病学， 2011， 硕士

【摘要】 目的:本文旨在研究结节性硬化症脑部MRI病灶特征与癫痫之间的关系。方法:首先通过病例回顾搜集患者的癫痫临床特征。然后利用医学图像分析软件对入选患者的T1加权相和FLAIR相的三维MRI图像进行自动分割处理,从而获取病灶范围。为了度量病灶负荷量,提出以下概念:病灶/全脑比例(TLBP),即全脑范围内的病灶体积占全脑体积的比例,以及皮质病灶/皮质比例(CLCP),即皮质范围内病灶体积所占皮质体积的比例。最后对癫痫临床特征以及MRI病灶负荷量进行分别统计描述,并计算其相互关系。结果:24例患者入选本研究。研究发现:FLAIR相TLBP和CLCP皆与癫痫首发年龄反相关,同时癫痫首发年龄也受到新生儿窒息史的影响。有婴儿痉挛史的患儿相比无婴儿痉挛史的患儿有较高的FLAIR相TLBP和CLCP。在经历过婴儿痉挛的患儿中,继续痫性痉挛的患儿较转变为其他癫痫发作类型的患儿有较高的FLAIR相CLCP。在无婴儿痉挛史的患儿中,主要发作类型不同的患者之间病灶负荷量无显著差异。T1相病灶负荷量与癫痫首发年龄和发作类型均不相关。结论:FLAIR相病灶负荷量与首发年龄以及发作类型这两个癫痫特征之间存在明显相关性,尤其是皮质区域的病灶负荷量在癫痫的评估中具有重要意义。T1相病灶负荷量和癫痫特征的关系仍有待进一步研究。更多还原

【Abstract】 Purpose: The purpose of this study was to reveal the association between MRI brain lesion load and epileptic characteristics.Methods: The epileptic characteristics were collected through retrospective chart review. Three-dimensional T1 and FLAIR MRI data were obtained and brain lesions were segmented with automatic algorithms of medical image processing softwares. The conceptions total lesion/brain proportion (TLBP), the proportion of total brain volume occupied by lesions, and Cortical lesion/cortex proportion (CLCP), the proportion of cortical volume occupied by lesions, were proposed as measurements of MRI lesion load. Afterward, the epileptic characteristics and MRI lesion load were statistically described and the association between them were tested.Results: 24 patients were included. Both FLAIR-TLBP and FLAIR-CLCP were found inversely related to age at seizure onset, which was also influenced by perinatal asphyxia. Both FLAIR-TLBP and FLAIR-CLCP were significantly higher in patients with a history of infantile spasms than in those without. Epileptic spasms was distinguished from other seizure types originated from infantile spasms, when comparing the mean FLAIR-CLCP of the patients with continuous spasms after infancy with that of the patients with transformed seizure types. In patients without a history of infantile spasms, no difference of lesion load were found between groups with different dominant seizure phenotypes. T1 lesion load were related to neither age at seizure onset nor seizure types.Conclusion: There was significant relation between FLAIR, especially cortical, lesion load and epileptic characteristics (age at seizure onset and the seizure types). The association between T1 lesion load and epileptic characteristics still need to be further studied.更多还原