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目的分析部分发作(PS)及部分继发全面发作癫痫患者(SGC)脑弥散张量的改变情况。方法本研究纳入11例PS患者,11例SGC患者及15例正常对照者。弥散张量成像采集采用3.0T磁共振仪,用15个方向的单次激发平面回波序列。采集数据用DTI-Studio软件计算每个受试者表观弥散系数图,然后用基于体素(VBA)的方法进行分析,取校正后P<0.05为有意义区域。基于VBA的发现,本研究对双侧丘脑的表现弥散系数图(ADC)值进行感兴趣区(ROI)分析,采用SPSS 11.5统计软件包进行统计分析,以P<0.05为差异有统计学意义。结果VBA结果显示PS和SGC患者均存在双侧上纵束、胼胝体及双侧颞叶等区域白质ADC值的增加。但双侧丘脑ADC值增加只有在SGC患者才能观察到。ROI分析结果同样显示SGC患者双侧丘脑ADC值的增加。结论本研究结果支持皮质丘脑环路假说,即丘脑功能的异常导致继发全面癫痫的发作。
Objective To analyze the changes of diffuse tensor tensions in partial seizures (PS) and partial secondary generalized epilepsy patients (SGC). Methods The study included 11 PS patients, 11 SGC patients and 15 normal controls. Diffusion tensor imaging using 3.0T magnetic resonance device, with 15 directions of single-shot plane echo sequence. Data were collected using the DTI-Studio software to calculate the apparent diffusion coefficient of each subject, and then analyzed by the method based on voxel (VBA), take the corrected P <0.05 as the meaningful region. Based on the findings of VBA, this study analyzed ROI of bilateral thalamus with statistical diffusion coefficient (ADC) values and performed statistical analysis using SPSS 11.5 statistical software package. P <0.05 was considered statistically significant. Results The results of VBA showed that both the PS and SGC patients had an increase of white matter ADC value in bilateral superior longitudinal bundle, corpus callosum and bilateral temporal lobe. However, bilateral thalamic ADC values increased only in patients with SGC can be observed. The ROI analysis also showed an increase in ADC values of bilateral thalamus in patients with SGC. CONCLUSIONS Our results support the hypothesis that the hypothalamic-thalamic loop hypothesis that abnormalities in thalamic brain function lead to secondary generalized epileptic seizures.