摘要
目的:通过分析磁共振弥散张量成像(DTI)、磁共振波谱成像(1H-MRS)在诊断软化灶继发癫痫中的灵敏度和特异度,探索多模态磁共振成像在诊断脑软化灶继发癫痫中的应用价值.方法:收集 2021 年 10 月—2023 年 9 月在菏泽医学专科学校附属医院就诊并通过常规磁共振扫描证实有脑软化灶患者 140 例,其中软化灶继发癫痫患者 40 例(软化灶癫痫组)、软化灶非癫痫患者 100 例(软化灶非癫痫组),均进行多模态磁共振扫描.结果:软化灶癫痫主要病因为胶质瘤手术、脑外伤手术,软化灶非癫痫主要病因为脑梗死、脑出血;两组分数各向异性(FA)、平均弥散率(MD)、N-乙酰天冬氨酸(NAA)/[胆碱(Cho)+肌酸(Cr)]、NAA/Cr及NAA/Cho值比较,差异均有统计学意义(P＜0.05);FA、MD、NAA/(Cho+Cr)、NAA/Cr及NAA/Cho值诊断脑软化灶继发癫痫相的ROC曲线下面积分别为 0.897、0.868、1.000、0.997 及 0.993,诊断效能均较高(P＜0.05).结论:多模态磁共振成像在诊断脑软化灶继发癫痫中具有应用价值,通过检测FA、MD、NAA/(Cho+Cr)、NAA/Cr及NAA/Cho值可为脑软化灶继发癫痫的早诊断、治疗和预防提供依据和方向.
Abstract
Objective To explore the sensitivity and specificity of diffusion tensor imaging(DTI)and proton magnetic resonance spectroscopy(1H-MRS)in diagnosing epilepsy secondary to cerebral softening,and to investigate the application value of multimodal magnetic resonance imaging in the diagnosis of epilepsy secondary to cerebral softening.Methods 140 patients who received medical treatment at The Affiliated Hospital of Heze Medical College from October 2021 to September 2023 and were confirmed to have cerebral softening lesions through routine magnetic resonance imaging scans were collected.A total of 40 patients with epilepsy secondary to cerebral softening(soft focal epilepsy group)and 100 patients with cerebral softening without epilepsy(soft lesion non epileptic group)confirmed by routine magnetic resonance imaging.All patients underwent multimodal magnetic resonance imaging.Results The main causes of softening-related epilepsy were glioma surgery and traumatic brain surgery,while the main causes of softening without epilepsy were cerebral infarction and cerebral hemorrhage.There were significant differences in fractional anisotropy(FA),mean diffusivity(MD),N-acetylaspartate(NAA)/(choline+creatine)(Cho+Cr),NAA/Cr,and NAA/Cho values between the two groups(P＜0.05).The area under ROC curve of FA,MD,NAA/(Cho+Cr),NAA/Cr and NAA/Cho values for the diagnosis of secondary epileptic phase of encephalomalacia was 0.897,0.868,1.000,0.997 and 0.993,respectively,all of which had high diagnostic efficiency(P＜0.05).Conclusion Multimodal magnetic resonance imaging has application value in the diagnosis of epilepsy secondary to cerebral softening.Detection of FA,MD,NAA/(Cho+Cr),NAA/Cr,and NAA/Cho values can provide a basis and direction for the early diagnosis,treatment,and prevention of epilepsy secondary to cerebral softening.
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