MRI颅脑黑水+脂肪抑制序列在海马硬化致儿童及青少年颞叶癫痫的临床诊断价值

侯艳霞; 石俊英; 何忠

doi:10.12122/j.issn.1674-4500.2019.02.08

MRI颅脑黑水+脂肪抑制序列在海马硬化致儿童及青少年颞叶癫痫的临床诊断价值

doi: 10.12122/j.issn.1674-4500.2019.02.08

1.
珠海市妇幼保健院放射科
2.
儿科，广东珠海 519000
3.
郑州市人民医院，河南郑州 453000

详细信息

作者简介:
侯艳霞，主治医师，E-mail：870632697@qq.com

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出版历程
- 收稿日期: 2019-01-12
- 刊出日期: 2019-04-01

Clinical diagnostic value of MRI t2 tirm dark-fluid in children and adolescents with temporal lobe epilepsy caused by hippocampus sclerosis

摘要

摘要: 目的探讨MRI颅脑黑水+脂肪抑制序列相比磁共振其它多序列扫描方法的特有优势。方法应用Siemens Avanto Dot 1.5TMR机对60例经临床证实为海马硬化患儿行多序列扫描，比较各常规序列脑内病灶显示率，做相应统计学比较，并对所获图像进行分析。结果左侧海马硬化21例，右侧36例，双侧3例。在常规T2WI TES、FLAIR、T2 tirm及t2 tirm dark-fluid序列上表现为高信号的分别有28例、39例、42例、51例。经统计学分析，颅脑黑水+脂肪抑制序列的病灶显示率最高，且与常规T2WI TES、FLAIR、T2 tirm的差异均有统计学意义（P<0.05），FLAIR与T2 tirm序列病灶显示率差异无统计学意义（P>0.05）。结论MRI作为诊断海马硬化的首选设备和方法，影像科医生应充分重视颅脑黑水+脂肪抑制序列t2 tirm dark-fluid的重要性，它可在显著缩短检查时间的基础上提高诊断准确性，为临床医生提供精确的定位和定性诊断，值得今后在实际工作中参考使用。
- 海马硬化 /
- 颞叶癫痫 /
- 黑水+脂肪抑制序列
Abstract: ObjectiveTo investigate the unique advantages of MRI t2 tirm dark-fluid in the imaging diagnosis of temporal lobe epilepsy caused by hippocampus sclerosis in children and adolescents compared with other multisequence scanning methods.Methods60 cases of children clinically confirmed as hippocampus sclerosis were scanned in multiple sequences using a Siemens Avanto Dot 1.5 TMR machine. The display rates of each sequence of intracranial lesions were compared, statistical comparisons were made, and the images obtained were analyzed.ResultsLeft hippocampus sclerosis in 21 cases. 36 cases on the right side and 3 cases on both sides. In the normal T2WI TES, FLAIR, T2 tirm and t2 tirm dark-fluid sequences, 28 cases, 39 cases, 42 cases and 51 cases respectively showed high signals. After statistical analysis, the incidence of t2 tirm dark-fluid sequences lesion was highest, and the differences with conventional T2WI TES, FLAIRand T2 tirm were statistically significant (P<0.05). The difference between the FLAIR and t2 tirm sequences (P>0.05) was not statistically significant.ConclusionMRI is the preferred device and method for diagnosing hippocampus sclerosis. Imaging doctors should pay full attention to the importance of T2 tirm dark-fluid in brain black water+fat inhibition sequence. It can significantly shorten the time of examination to improve the accuracy of diagnosis, for clinicians to provide accurate positioning and qualitative diagnosis, worthy of reference in the future work.
- hippocampus sclerotic /
- temporal lobe epilepsy /
- t2 tirm dark-fluid

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图 1 本院某13岁患儿各序列图像对比及其病理结果

手术后病理回报镜下海马齿状回形态稍异常神经元, 胶质细胞轻度增生; A: 常规T2W; B: FLAIR; C: T2 tirm; D: 颅脑黑水+脂肪抑制序列; E: 病理(×100, HE染色).

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表 1 4种MR序列对60例经临床证实为海马硬化致癫痫患儿显示结果（n=60，%）

MRI扫描序列	海马显示异常信号	正常信号
T2 TSE	28（46.7%）	32（57.6%）
FLAIR	39（65%）	21（40.9%）
T2 tirm	42（70%）	18（36.4%）
黑水+脂肪抑制序列	51（85%）	9（22.7%）
合计	160（66.7%）	80（33.3%）
χ²=20.250 P=0.00

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表 2 两两序列检出数比较

MRI扫描序列	χ²	P
t2tirm dark-fluid/T2 tse	19.599	0.000
t2tirm dark-fluid/FLAIR	6.400	0.011
t2tirm dark-fluid/T2 tirm	3.871	0.049
FLAIR/T2 tse	4.089	0.043
T2 tirm /FLAIR	0.342	0.559
T2 tirm/T2 tse	6.720	0.010

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