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目的探讨成人颞叶癫痫发作间期单侧和双侧痫性放电CT灌注成像的变化。方法将21例颞叶癫痫患者根据视频脑电图监测分为单侧痫性放电组11例、双侧痫性放电组10例,两组患者均在发作间期行CT灌注成像检查,计算每例患者双侧颞叶脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、平均通过时间(mean transit ti me,MTT)的灌注参数,并比较每组患者颞叶CBF、CBV、MTT以及两组的CBF、CBV、MTT不对称指数(asymmetry index,AI)。结果21例患者头颅CT平扫均无异常,每组患者发作间期双侧颞叶CBF、CBV、MTT差异无统计学意义(P>0.05),两组患者CBF不对称指数差异有统计学意义(t=2.269,P=0.035),CBV和MTT不对称指数差异无统计学意义(P>0.05),在单侧痫性放电组中,痫性放电侧颞叶脑血流量较对侧有所减低,但比较差异无统计学意义(t=-2.093,P=0.063)。结论颞叶癫痫CT灌注成像显示颞叶区发作间期单侧痫性放电较双侧痫性放电脑血流量不对称。
Objective To investigate the changes of CT perfusion imaging in unilateral and bilateral epileptiform discharges in adults with temporal lobe epilepsy. Methods Twenty-one patients with temporal lobe epilepsy were divided into 11 cases of unilateral epileptiform discharge and 10 cases of bilateral epileptic discharge according to the video electroencephalogram (EEG). The patients in both groups were examined with CT perfusion imaging in the interictal interval, The perfusion parameters of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in patients with bilateral temporal regions were compared. The temporal lobe CBF, CBV, MTT and CBF, CBV, MTT asymmetry index (AI) in both groups. Results There was no abnormal CT scan in all the 21 cases. There was no significant difference in CBF, CBV and MTT between bilateral temporal lobes in each group (P> 0.05). There was significant difference in asymmetric index of CBF between the two groups (t = 2.269, P = 0.035). There was no significant difference in asymmetry index between CBV and MTT (P> 0.05). In the unilateral epileptic discharge group, the cerebral blood flow in the temporal lobe of the epileptic discharge side was higher than that in the contralateral Reduce, but the difference was not statistically significant (t = -2.093, P = 0.063). Conclusion CT perfusion imaging in temporal lobe epilepsy shows that the unilateral epileptiform discharge in the temporal lobe interictal area is asymmetric compared with bilateral epileptic discharge.