Abstract:

Objective  To analyze the changes of hippocampus blood perfusion and hippocampal volume in patients with temporal lobe epilepsy (TLE) caused by hippocampal sclerosis (HS) using single-photon emission-computed tomography (SPECT) and MRI, so as to explore the effect on localization of epileptogenic focus in TLE patients.  Methods  Eighteen TLE patients and 3 healthy controls underwent 99Tcm-ethyl cysteinate dimer (99Tcm-ECD) SPECT. Eighteen TLE patients and 21 healthy controls were performed MRI. The relative cerebral blood flow (rCBF) and hippocampal volume were calculated and compared between 2 groups. The correlation between rCBF in ipsilateral hippocampus and hippocampal volume of TLE patients was analyzed. Results SPECT showed rCBF in ipsilateral hippocampus [(46.04 ± 7.94) ml/(100 g·min)] was significantly decreased compared with contralateral hippocampus in TLE patients [(54.76 ± 9.62) ml/(100 g·min); t = -2.966, P = 0.005] and bilateral hippocampus in healthy controls [(64.87 ± 7.28) ml/(100 g·min); t = -4.824, P = 0.000]. The volume of ipsilateral hippocampus [(1.69 ± 0.39) cm³] was significantly smaller than that of contralateral hippocampus in TLE patients [(2.68 ± 0.41) cm³; t = -7.410, P = 0.000] and bilateral hippocampus in healthy controls [(3.50 ± 0.39) cm³; t = -16.340, P = 0.000]. The rCBF of ipsilateral hippocampus had positive correlation with the volume of corresponding hippocampus in TLE patients (r = 0.394, P = 0.017).  Conclusions  Both rCBF and the volume of ipsilateral hippocampus were reduced in patients with TLE caused by HS, and there was positive correlation between the two. It was helpful for preoperative localization of epileptogenic focus to combine SPECT with MRI.

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摘要：

目的 探讨SPECT 脑血流灌注显像结合MRI测量海马体积对海马硬化致颞叶癫痫患者致痫灶的定位价值。方法 采用99Tcm-双半胱乙酯（99Tcm-ECD）SPECT 脑血流灌注显像对双侧海马血流灌注进行定性和半定量分析，MRI 测量双侧海马体积，分析海马硬化致颞叶癫痫（颞叶癫痫组）患者患侧海马相对脑血流量与相应区域海马体积的相关性。结果 颞叶癫痫组患者患侧海马相对脑血流量［（46.04 ± 7.94）ml/（100 g·min）］低于对侧［（54.76 ± 9.62）ml/（100 g·min）；t = -2.966，P = 0.005］和正常对照者［（64.87 ± 7.28）ml/（100 g·min）；t = -4.824，P = 0.000］，且海马体积［（1.69 ± 0.39）cm³］小于对侧［（2.68 ± 0.41）cm³；t = -7.410，P = 0.000］和正常对照者［（3.50 ± 0.39）cm³；t = -16.340，P = 0.000］。海马硬化致颞叶癫痫患者患侧海马相对脑血流量与相应区域海马体积呈正相关（r = 0.394，P = 0.017）。结论 海马硬化致颞叶癫痫患者患侧海马相对脑血流量降低、海马体积缩小，二者呈正相关。SPECT 脑血流灌注显像结合MRI测量海马体积，可以作为致痫灶切除术前准确定位的参考依据。

关键词: 癫痫, 颞叶, 海马, 体层摄影术, 发射型计算机, 单光子, 磁共振成像