以癫痫为主要症状的结节性硬化症脑部致痫灶的影像特点

发布时间：2018-01-21 08:24

本文关键词： 结节性硬化癫痫体层摄影术 X线计算机磁共振成像　出处：《临床放射学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨以癫痫为主要症状的结节性硬化症(TSC)患者脑部致痫灶的影像学特点。方法搜集16例临床诊断TSC患者,13例行脑部致痫灶外科手术治疗,总结TSC致痫灶的好发部位及影像学特点。结果 CT检出皮层结节21个,18个结节部分钙化。MRI检出皮质结节52个,表现为皮层局部脑回增厚、肥大,T1WI呈等或稍低信号,T2WI呈等或稍高信号,Flair呈稍高信号,DWI呈等信号,增强扫描不强化,结节的钙化部分在各序列均呈稍低信号。22个结节伴皮质下脑白质病变。结节位于额叶18个,颞叶13个,顶叶11个,枕叶7个,扣带回3个。手术共切除皮质结节24个,15个为部分钙化结节。10个结节伴皮质下脑白质病变。结节位于额叶10个,颞叶6个,左顶叶5个,枕叶2个,扣带回1个。结论皮质结节与癫痫发作密切相关,皮层局部脑回增厚、肥大伴皮质下白质病变及部分钙化是TSC致痫灶的影像特点,皮质结节分布较多的脑叶依次为额叶、颞叶、顶叶。致痫结节的确定需结合发作期和发作间期脑电图的异常放电区域与MRI皮质结节所在脑叶的一致性进行判断。
[Abstract]:Objective to investigate the imaging features of epileptogenic foci in the brain of patients with tuberous sclerosis with epilepsy as the main symptom. Methods 16 patients with TSC were collected. 13 cases were treated with surgical treatment of brain epileptogenic foci, and the location and imaging features of epileptiform foci caused by TSC were summarized. Results 21 cortical nodules were detected by CT. Fifty-two cortical nodules were found in 18 nodules with partial calcification. MRI showed thickening of the cortical gyrus and iso-or slightly hypointense T _ 2WI in hypertrophic T _ 1WI. Flair showed a slight hyperintense signal intensity, no enhancement, calcification of the nodules in all sequences, 22 nodules with subcortical white matter lesions, and 18 nodules in the frontal lobe. There were 13 temporal lobes, 11 parietal lobes, 7 occipital lobes and 3 cingulate gyrus. 15 were partial calcified nodules. 10 nodules were located in the frontal lobe, 6 in the temporal lobe, 5 in the left parietal lobe and 2 in the occipital lobe. Conclusion Cortical nodules are closely related to epileptic seizures, cortical regional gyrus thickening, hypertrophy with subcortical white matter lesions and partial calcification are the imaging features of epileptic foci caused by TSC. The frontal lobe and temporal lobe were the most frequently distributed cortical nodules. The determination of parietal lobe and epileptiform nodules should be combined with the consistency of abnormal discharge area of EEG during attack and interictal period with that of MRI cortical nodules in the lobes of the brain.
【作者单位】：长江航运总医院武汉脑科医院影像科;
【分类号】：R445.2;R596;R747.9
【正文快照】： 结节性硬化症(tuburoussclerosis complex,TSC)又称Bourneville病,是主要由TSC1或TSC2基因突变引起的常染色体显性遗传性疾病[1],常累及中枢神经系统、皮肤、肾脏、视网膜、心脏等全身多个器官,主要特点为多器官错构瘤[2]。癫痫、皮脂腺瘤、智力发育迟缓是临床典型的三大症状,

【相似文献】