摘要
目的:利用自动脑分割技术(FreeSurfer)分析海马硬化型颞叶内侧癫痫(MTLE-HS)患者颞叶亚区白质体积的变化,探讨该技术在MTLE-HS中的临床应用价值.方法:搜集2021年1月至2023年9月经术后病理或 MRI诊断为MTLE-HS的患者53例,其中左侧 MTLE-HS(LMTLE-HS)30例,右侧MTLE-HS(RMTLE-HS)23例;同期招募性别、年龄相匹配的健康对照者43例.所有受试者均在3.0T磁共振上行T,加权三维磁化强度预备梯度回波序列(3D-T1WI-MPRAGE)扫描.使用FreeSurfer软件对T1-MARAGE图像进行全脑分割,搜集颞叶亚区(颞上回后部、颞极、颞横回、颞上回、颞中回、颞下回、梭状回、海马旁回)的白质体积数据,采用配对t检验比较对照组左、右两侧颞叶各亚区白质体积的差异,采用独立样本t检验分别比较对照组与LMTLE-HS组、RMTLE-HS组患侧、对侧之间颞叶各亚区白质体积的差异.结果:对照组左、右两侧颞横回、颞上回、颞中回、颞下回、梭状回的白质体积差异有统计学意义(P＜0.05).对照组左、右两侧分别与LMTLE-HS组、RMTLE-HS组患侧、对侧进行比较,结果显示对照组左侧与LMTLE-HS组患侧颞极、颞横回、颞上回、颞中回、颞下回、梭状回、海马旁回的白质体积差异有统计学意义(P＜0.05),对照组右侧与LMTLE-HS组对侧颞上回后部、颞上回、颞中回、颞下回、梭状回、海马旁回及RMTLE-HS组患侧颞上回后部、颞中回、颞下回、梭状回、海马旁回的白质体积差异有统计学意义(P＜0.05),其余亚区体积差异无统计学意义(P＞0.05).结论:基于自动脑分割技术的MTLE-HS颞区白质体积定量分析对颞叶癫痫术前评估及手术方式的选择具有一定意义.
Abstract
Objective:To analyze the changes in white matter volume of the temporal lobe subre-gions in patients with medial temporal lobe epilepsy with hippocampal sclerosis(MTLE-HS)by auto-matic brain segmentation technique(FreeSurfer)and to investigate its clinical application value in MTLE-HS.Methods:A total of 53 patients diagnosed with MTLE-HS through postoperative pathology or magnetic resonance imaging(MRI)from January 2021 to September 2023 were collected,including 30 patients with left MTLE-HS(LMTLE-HS)and 23 patients with right MTLE-HS(RMTLE-HS).Meanwhile,43 gender-and age-matched healthy controls were recruited.All participants underwent T1-weighted three-dimensional magnetization-prepared rapid acquisition gradient echo sequence(3D-T1 WI-MPRAGE)scanning on a 3.0T MR.The FreeSurfer software was used to perform whole-brain segmentation on the T1-MPRAGE images,and white matter volume data of the temporal lobe subre-gions(posterior superior temporal gyrus,temporal pole,superior temporal gyrus,middle temporal gy-rus,inferior temporal gyrus,fusiform gyrus and parahippocampal gyrus)were collected.Paired t-tests were used to compare the differences in white matter volumes of each subregion between the left and right temporal lobes in the control group.Independent samples t-tests were used to compare the differ-ences in white matter volumes of each temporal lobe subregion between the control group and the LM-TLE-HS and RMTLE-HS groups,as well as between the affected and unaffected sides within the LM-TLE-HS and RMTLE-HS groups.Results:There were statistically significant differences in white mat-ter volumes of the transverse temporal gyrus,superior temporal gyrus,middle temporal gyrus,inferior temporal gyrus,fusiform gyrus and parahippocampal gyrus between the left and right sides in the con-trol group(P＜0.05).Significant differences in white matter volumes were found in the affected side of the LMTLE-HS group compared to the left side of the control group(temporal pole,transverse temporal gyrus,superior temporal gyrus,middle temporal gyrus,inferior temporal gyrus,fusiform gy-rus and parahippocampal gyrus)(P＜0.05).Significant differences in white matter volumes were found in the unaffected side of the LMTLE-HS group(posterior superior temporal gyrus,superior temporal gyrus,middle temporal gyrus,inferior temporal gyrus,fusiform gyrus and parahippocampal gyrus)and in the affected side of the RMTLE-HS group(posterior superior temporal gyrus,middle temporal gyrus,inferior temporal gyrus,fusiform gyrus and parahippocampal gyrus)compared to the right side of the control groups(P＜0.05).There were no statistically significant differences in volume among the other subregions(P＞0.05).Conclusion:The quantitative analysis of temporal lobe white matter volume using the automatic brain segmentation technique is of certain significance for preoper-ative evaluation and surgical approach selection in patients with hippocampal sclerotic medial temporal lobe epilepsy.
基金项目
宁夏回族自治区重点研发计划类项目(2020BEG03026)
宁夏自然科学基金项目(2023AAC03611)
维普
万方数据