發(fā)布時間：2018-04-21 22:13

  本文選題：結(jié)構(gòu)磁共振 + 腦灰質(zhì)體積�。� 參考：《深圳大學》2017年碩士論文

【摘要】：目的:內(nèi)側(cè)顳葉癲癇(mesial temporal lobe epilepsy,MTLE)是一種常見的難治性癲癇,其中海馬硬化(hippocampal sclerosis,HS)被認為是引發(fā)MTLE最常見的因素。伴海馬硬化的內(nèi)側(cè)顳葉癲癇(mesial temporal lobe epilepsy with hippocampal sclerosis,MTLE-HS)的長期發(fā)作引起患者相關腦結(jié)構(gòu)的變化,對患者大腦發(fā)育將造成嚴重的影響,甚至引起患者記憶空間分辨等功能缺陷。因此,研究MTLE-HS患者的腦結(jié)構(gòu)變化對了解MTLE-HS的內(nèi)在病理機制很有意義。方法:我們收集13例左側(cè)伴海馬硬化的內(nèi)側(cè)顳葉癲癇(left mesial temporal lobe with hippocampal sclerosis,LMTLE-HS)、6例右側(cè)伴海馬硬化的內(nèi)側(cè)顳葉癲癇(right mesial temporal lobe with hippocampal sclerosis,RMTLE-HS)的兒童患者,和20例性別比例、年齡無顯著差異的健康兒童的T1加權三維磁化強度預備梯度回波序列磁共振圖像。我們采用基于體素的形態(tài)學方法(voxel-based morphology,VBM),、基于表面的形態(tài)學方法(surface-based morphology,SBM),和基于圖論(graph-based theory)的腦網(wǎng)絡連接方法分別對LMTLE-HS/RMTLE-HS的灰質(zhì)體積、皮層厚度和結(jié)構(gòu)網(wǎng)絡進行統(tǒng)計分析,然后對以上相關形態(tài)學參數(shù)進行組間比較,分析患兒相對于正常兒童的形態(tài)學異常。結(jié)果:VBM研究發(fā)現(xiàn),LMTLE-HS在左側(cè)海馬旁回、杏仁核、顳中回、顳上回、額中回和雙側(cè)小腦等區(qū)域均表現(xiàn)出灰質(zhì)體積增大,在同側(cè)中央后回等區(qū)域表現(xiàn)出灰質(zhì)體積萎縮。RMTLE-HS在同側(cè)海馬旁回、額中回和頂下回表現(xiàn)出灰質(zhì)體積增大,并且在對側(cè)額葉、中央前回和頂上小葉表現(xiàn)灰質(zhì)體積萎縮。SBM研究發(fā)現(xiàn),LMTLE-HS組在左側(cè)額中回的皮層厚度變薄,右側(cè)顳下回的皮層厚度變厚。RMTLE-HS組在左側(cè)頂葉腹側(cè)、額中回、額上回、矩狀皮層、右側(cè)頂上回、枕葉腹側(cè)、中央后回和中央旁回、頂后回、中央后回皮層厚度變薄。腦結(jié)構(gòu)網(wǎng)絡分析發(fā)現(xiàn),LMTLE-HS/RMTLE-HS組的小世界屬性,網(wǎng)絡屬性和網(wǎng)絡穩(wěn)定性都遭到破壞,表現(xiàn)出較低的聚類屬性、較長的最短路徑長度、較低的全局效率和局部效率,并且在面對外來隨機和目的邊、節(jié)點攻擊時表現(xiàn)出較低的網(wǎng)絡穩(wěn)定性。結(jié)論:MTLE-HS患者的形態(tài)學結(jié)構(gòu)表現(xiàn)異常,腦網(wǎng)絡拓撲結(jié)構(gòu)遭到破壞,LMTLE-HS和RMTLE-HS表現(xiàn)出不同的形態(tài)學結(jié)構(gòu)和腦拓撲網(wǎng)絡。本研究從腦形態(tài)學和腦連接網(wǎng)絡層面上揭示了MTLE-HS的異常變化,為理解MTLE-HS的內(nèi)在病理機制提供了重要信息。
[Abstract]:Aim: mesial temporal lobe epilepsysyn (MTL) is a common intractable epilepsy, among which Hippocampal sclerosisHSs is considered to be the most common cause of MTLE. The long-term seizure of mesial temporal lobe epilepsy with hippocampal hippocampal LE-HS) in the medial temporal lobe with hippocampal sclerosis may cause changes in the related brain structure of the patients, which will have a serious effect on the development of the patients' brain, and even lead to functional defects such as spatial resolution of memory in the patients. Therefore, it is important to study the changes of brain structure in patients with MTLE-HS in order to understand the underlying pathological mechanism of MTLE-HS. Methods: thirteen cases of left mesial temporal lobe with hippocampal hippocampal LLE-HSN with left hippocampal sclerosis were collected from 13 children with right mesial temporal lobe with hippocampal sclerosism RMTLE-HSM, and 20 cases with sex ratio. There was no significant age difference in T 1 weighted 3 D magnetization pregradient echo sequence MRI in healthy children. The volume of gray matter, the thickness of cortex and the structure network of LMTLE-HS/RMTLE-HS were statistically analyzed using voxel-based morphology-based morphology-based morphology-based morpholog@@ Then the morphological parameters above were compared among groups to analyze the morphological abnormalities of children compared with normal children. Results in the VBM study, LMTLE-HS showed increased gray matter volume in the left parahippocampal gyrus, amygdaloid nucleus, middle temporal gyrus, superior temporal gyrus, middle frontal gyrus and bilateral cerebellum. In the ipsilateral posterior central gyrus, the volume of gray matter atrophied. RMTLE-HS was found in the ipsilateral parahippocampal gyrus, and the middle frontal gyrus and inferior parietal gyrus showed increased gray matter volume, and in the contralateral frontal lobe. The volume atrophy of gray matter in precentral gyrus and superior parietal lobule. SBM study showed that the cortex thickness of left middle frontal gyrus was thinned in LMTLE-HS group, and the thickness of right inferior temporal gyrus was thicker. RMTLE-HS group was in left parietal lobe ventral side, middle frontal gyrus, superior frontal gyrus, moment cortex. Right superior parietal gyrus, ventral occipital lobe, posterior central gyrus and paracentral gyrus, posterior parietal gyrus, posterior central gyrus cortical thickness thinning. The analysis of brain structure network found that the small world attribute, network attribute and network stability of LMTLE-HSR / RMTLE-HS group were destroyed, showing lower clustering attribute, longer shortest path length, lower global efficiency and local efficiency. In the face of external random and destination side, node attack shows low network stability. Conclusion the morphological structure of the patients with brain network is abnormal, and the topological structure of brain network is damaged. LMTLE-HS and RMTLE-HS show different morphological structure and brain topological network. This study revealed the abnormal changes of MTLE-HS in brain morphology and brain junction network and provided important information for understanding the underlying pathological mechanism of MTLE-HS.
【學位授予單位】：深圳大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R742.1

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