静息态功能磁共振成像局灶性癫痫活动定位研究

发布时间：2018-05-27 17:08

本文选题：局灶性癫痫 + 脑电联合功能磁共振成像　；参考：《南京大学》2014年硕士论文

【摘要】：目的：对比低频振幅(ALFF)分析技术与脑电联合功能磁共振成像(EEG-fMRI)技术对局灶性癫痫活动检测的能力,评估ALFF分析技术在局灶性癫痫活动定位中的应用价值。资料和方法：24例有明确病理灶存在的局灶性癫痫患者纳入,分别于GE1.5TMRI仪(17例)及Siemens 3.0T MRI仪(7例)下行同步EEG-fMRI数据采集。以广义线性模型(GLM)方法对间期痫样发放(IEDs)相关fMRI活动的检测为基础；再采用ALFF分析技术,使用个例患者与大样本正常受试者基线数据进行两样本t检验(P0.05,Alphasim校正),检测局灶性癫痫脑区ALFF改变的位置。最后以临床或手术癫痫定位结果为标准,对比分析两种fMRI技术对癫痫活动的检测能力。结果：在36次有效癫痫EEG-fMRI数据中,两种分析技术均有明显的BOLD结果检出。EEG-fMRI定位结果与临床定位结果相关者15次(15/36,41.66%)；ALFF结果与临床定位结果相关者24次(24/36,66.66%)。两者定位结果一致且均与临床定位结果相关者9次(9/36,25.00%),两者定位结果均与临床定位结果不符者6次(6/36,16.67%)。结论：EEG-fMRI能有效地检出癫痫活动相关脑区；基于ALFF的fMRI技术则可在不需同步EEG信息的情况下,取得更好的癫痫活动检测效果,为癫痫活动定位提供了一种新的fMRI分析技术。目的：观测ALFF和功能连接在内侧颞叶癫痫中相反的改变模式,评估两种方法的联合应用在癫痫活动检测中的应用价值。资料和方法：采集47例内侧颢叶癫痫患者与32名正常志愿者静息态fMRI数据,患者组同步采集EEG数据且在采集期间均检测到间期痫样放电。ALFF、FCD数据预处理后进行相关标准化运算得到ALFF-FCD对比脑图,通过两样本t检验分别观察mTLE患者相对正常对照组ALFF、FCD及ALFF-FCD的改变脑区；左、右侧mTLE患者选取相应的左右内侧颞叶为ROI,采用二分法/ROC曲线方式评估三种成像方法的定侧效能；最后采用相关分析观察mTLE患者FCD、ALFF及ALFF-FCD改变脑区与间期痫样放电数目及癫痫病程的关系。结果：与正常对照组相比,mTLE患者发作间期ALFF增加区与FCD减低区均主要分布于损伤侧的颞区,而DMN脑区在两种方法中均呈减低改变。ALFF-FCD联合使用较单独任一种方法能更有效的区分mTLE患者与正常被试(区分L-mTLE与HC的准确度为0.95,R-mTLE与HC中为0.92)。基于体素的相关分析显示,间期痫样放电数目在内侧颞叶与ALFF呈正相关,与FCD呈负相关,后扣带回和顶叶与ALFF和FCD均呈负相关；病程在内侧颞叶,后扣带回及顶叶与ALFF和FCD均呈负相关,顶叶与ALFF-FCD结果呈正相关(P0.05,FDR校正)。结论：mTLE相关脑区振幅及功能连接的不匹配性改变可以增加癫痫活动的检测效能,癫痫慢性损伤在ALFF和FCD中均能引起DMN的降低。综合多个成像方法有助于深入探究癫痫的病理生理机制。
[Abstract]:Objective: To compare the ability of low-frequency amplitude (ALFF) analysis and EEG combined functional magnetic resonance imaging (EEG-fMRI) to detect focal epileptic activity and evaluate the value of ALFF analysis in the localization of focal epileptic activities. Data and methods: 24 cases of focal epileptic patients with clear foci were included in GE1., respectively, in GE1. 5TMRI (17 cases) and Siemens 3.0T MRI (7 cases) synchronous EEG-fMRI data acquisition. Based on the generalized linear model (GLM) method for the detection of fMRI activity associated with interphase epileptiform (IEDs), and ALFF analysis technique, a two sample t test (P0.05, Alphasim correction) is used in a case patient and a large sample of normal subjects. The location of ALFF changes in the focal epileptic region of the focal epilepsy was detected. Finally, the detection ability of two fMRI techniques for epileptic activity was compared with the results of clinical or surgical epileptic localization. Results: in the 36 effective epileptic EEG-fMRI data, the two analysis techniques had obvious BOLD results to detect the results of.EEG-fMRI localization and the clinical location results. 15 times (15/36,41.66%) and 24 times (24/36,66.66%) related to the results of clinical localization. The results were consistent and 9 times (9/36,25.00%) related to the clinical location results. The results of both localization and clinical localization were all 6 times (6/36,16.67%). Conclusion: EEG-fMRI can effectively detect the brain area of epileptic activity. ALFF based fMRI technology can achieve better epileptic activity detection effect without synchronization of EEG information, and provide a new fMRI analysis technique for epileptic location. Objective: To observe the reverse pattern of ALFF and functional connection in the medial temporal lobe epilepsy, and evaluate the combined application of two methods in epileptic activity detection. Data and methods: data and methods: the resting state fMRI data of 47 cases of medial temporal lobe epilepsy and 32 normal volunteers were collected. The patient group collected the EEG data synchronously and detected the interphase epileptiform discharge.ALFF during the acquisition period, and the correlation standardized operation was performed after the FCD data preprocessing to obtain the ALFF-FCD contrast brain map and the t test of two samples. The mTLE patients were compared with the normal control group ALFF, FCD and ALFF-FCD to change the brain region. The left and right mTLE patients selected the corresponding left and right medial temporal lobe to ROI, using the dichotomous /ROC curve to evaluate the lateral efficacy of the three imaging methods. Finally, the correlation analysis was used to observe the FCD in mTLE patients, ALFF and ALFF-FCD to change the brain area and interphase epileptiform. The relationship between the number of discharge and the course of epilepsy. Results: compared with the normal control group, both the ALFF increasing area and the FCD reduction area of the mTLE patients were mainly distributed in the temporal region of the injured side, while the DMN brain region was reduced in the two methods, and the combination of the.ALFF-FCD and the mTLE could be more effective to distinguish between the mTLE and the normal subjects. The accuracy of L-mTLE and HC was 0.95 and 0.92 in R-mTLE and HC. The correlation analysis based on voxel showed that the number of intertemporal epileptiform discharges was positively correlated with ALFF and negatively correlated with FCD. The posterior cingulate gyrus and parietal lobe were negatively correlated with ALFF and FCD, and the course was in the medial temporal lobe, and the posterior cingulate gyrus and parietal lobe were negatively related to ALFF and FCD, top. There is a positive correlation between the leaves and the results of ALFF-FCD (P0.05, FDR correction). Conclusion: the amplitude of mTLE related brain region and the mismatch of functional connection can increase the detection efficiency of epileptic activity. The chronic epileptic injury can cause the decrease of DMN in ALFF and FCD. Comprehensive multiple imaging methods are helpful to explore the pathophysiological mechanism of epilepsy in depth.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R742.1

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