磁共振灌注及静息态脑功能成像在颞叶癫痫中的应用研究

发布时间：2018-04-05 08:33

本文选题：颞叶癫痫　切入点：静息态　出处：《福建医科大学》2014年硕士论文

【摘要】：目的本研究联合动态磁敏感对比增强(dynamic susceptibility contrast-enhanced, DSC)灌注成像、动脉自旋标记(arterial spin labeling, ASL)技术及基于局部一致性分析方法的静息态功能磁共振成像,探讨颞叶癫痫(temporal lobe epilepsy,TLE)发作间期内侧颞叶的灌注改变及静息状态下脑功能变化特点。材料与方法采用西门子3.0T Trio Tim磁共振扫描仪对经过手术病理证实的15例发作间期右利手TLE患者及相匹配15例正常对照者行DSC、ASL扫描和静息态BOLD-fMRI检查。在工作站上重建出DSC的相对脑血容量(relative cerebral blood volume, rCBV)图及相对脑血流量(relative cerebral blood flow, rCBF)图,结合高分辨率解剖像,选取两侧内侧颞叶作为感兴趣区(region of interest, ROI),计算病例组及正常对照组两侧内侧颞叶的rCBV值、rCBF值,比较病例组及正常对照组两侧内侧颞叶rCBV、rCBF的不对称指数(asymmetry index, AI)的差异。应用Matlab7.8、SPM8软件包对ASL自动生成的rCBF图进行空间预处理和分析,得到并比较病例组和正常对照组间灌注差异的伪彩图。应用Matlab7.8、SPM8、 DPARSF和REST软件包对Resting state-fMRI图像进行数据预处理,采用局部一致性(Regional Homogeneity, ReHo)分析方法,比较病例组和正常对照组平均脑ReHo图的差异；提取两组被试两侧内侧颞叶的ReHo值,并比较两侧的差异。结果 1、正常对照组双侧内侧颞叶rCBV值、rCBF值无显著性差异(P0.05)。TLE组患侧rCBV值、rCBF值均低于对侧(P0.05)。TLE组AIrCBV、AIrCBF均高于正常对照组(P0.05)。 2、TLE患者内侧颞叶AIrCBF值、AIrCBV值均与病程呈正相关。 3、与正常对照组相比,TLE组ReHo值减低的脑区包括：右侧小脑后叶、左侧颞下回、左侧颞中回、左侧海马、胼胝体、丘脑、右侧楔前叶、左侧顶下小叶、左侧额中回及内侧额回,差异有统计学意义(P0.05)；而脑干、右侧中央前回、前扣带回、左侧海马旁回、左侧颞上回及右侧海马旁回的ReHo值明显升高,差异有统计学意义(P0.05)。正常对照组双侧内侧颞叶ReHo值无显著性差异(P0.05),TLE组患侧内侧颞叶ReHo值低于对侧,差异有统计学意义(P0.05)。结论 1、TLE发作间期患侧内侧颞叶rCBV值、rCBF值降低； 2、TLE发作间期静息状态下存在广泛的脑功能异常； 3、局部一致性分析方法可检出癫痫活动造成的局部脑组织血氧水平依赖信号同步性的改变,从而有助于癫痫病理生理机制的探索。
[Abstract]:PurposeIn this study, dynamic susceptibility contrast-enhanced perfusion imaging, arterial spin-labeled arterial spin labeling and resting functional magnetic resonance imaging based on local consistency analysis were studied.To investigate the changes of perfusion in the medial temporal lobe during the interictal phase of temporal lobe epilepsy and the changes of brain function in resting state.Materials and methods15 patients with interictal right-handed-hand TLE and 15 matched normal controls were examined by Siemens 3.0T Trio Tim magnetic resonance scanner (DSC-ASL) and rest BOLD-fMRI.The relative cerebral blood volume (rCBV) of DSC and the relative cerebral blood flow (rCBFV) of relative cerebral blood flow were reconstructed on workstation.Using bilateral medial temporal lobe as region of interest (ROI), the rCBV values of bilateral medial temporal lobes were calculated in case group and normal control group. The asymmetry index (asymmetric index) of rCBV rCBF was compared between the case group and the normal control group.The rCBF map automatically generated by ASL was preprocessed and analyzed by Matlab 7.8 SPM8 software package, and the pseudo-color images of perfusion difference between the case group and the normal control group were obtained and compared.Matlab-7.8 SPM8, DPARSF and REST software package were used to preprocess the data of Resting state-fMRI images, and the regional homogenicity (ReHoA) analysis method was used to compare the differences between the average ReHo map of brain in the case group and the normal control group, and to extract the ReHo values of the medial temporal lobes of the two groups.And compare the differences between the two sides.Result1. There was no significant difference in the rCBV value of bilateral medial temporal lobes in the normal control group. The rCBV value of the affected side in the TLE group was lower than that in the control group (P 0.05). The AIRCBF in the TLE group was higher than that in the normal control group (P 0.05).2 the AIrCBF value of medial temporal lobe and AIrCBV were positively correlated with the course of TLE.3Compared with the normal control group, the ReHo decreased in the right posterior cerebellar lobe, left inferior temporal gyrus, left middle temporal gyrus, left hippocampus, corpus callosum, thalamus, right anterior cuneate lobe, left inferior parietal lobule, left middle frontal gyrus and medial frontal gyrus.The difference was statistically significant (P 0.05), while the ReHo values of the right precentral gyrus, anterior cingulate gyrus, left parahippocampal gyrus, left superior temporal gyrus and right parahippocampal gyrus were significantly increased in the brain stem, and the difference was statistically significant (P 0.05).There was no significant difference in ReHo value of bilateral medial temporal lobe in normal control group. The ReHo value of medial temporal lobe in TLE group was lower than that in contralateral side, and the difference was statistically significant (P 0.05).Conclusion1the rCBV value and rCBF value of medial temporal lobe decreased in the interictal stage of TLE.(2) there were extensive brain dysfunction in the resting state of TLE during interictal period;3. The method of local consistency analysis can detect the synchronous changes of blood oxygen level of local brain tissue caused by epileptic activity, which is helpful to explore the pathophysiological mechanism of epilepsy.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1;R445.2

【参考文献】