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  本文關(guān)鍵詞： 靜息態(tài)磁共振腦功能成像 局部一致性 低頻振幅 低頻振幅分數(shù) 顳葉內(nèi)側(cè)癲癇　出處：《天津醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討基于ReHo、ALFF及fALFF的靜息態(tài)功能磁共振成像技術(shù)對于局灶性癲癇致癇灶檢查的可行性,并比較與其他技術(shù)(MRI、VEEG和FDG-PET)的診斷效能。 對象與方法：選擇經(jīng)臨床綜合診斷局灶性癲癇52例,采用SIEMENS TRIO3.0T MR掃描儀對所有患者行常規(guī)MRI、海馬高分辨成像以及靜息態(tài)fMRI掃描。采用Matlab7.1和SPM8對靜息態(tài)數(shù)據(jù)進行預(yù)處理。預(yù)處理后的數(shù)據(jù)采用REST1.4軟件行ReHo、ALFF和fALFF三種不同分析方法處理獲取激活圖,然后對三種分析方法的處理結(jié)果分別進行組水平和個體水平兩部分研究。第一部分：采用REST1.4軟件對20例單側(cè)顳葉內(nèi)側(cè)癲癇患者(13例左側(cè),7例右側(cè),對7例右側(cè)顳葉癲癇患者的圖像進行翻轉(zhuǎn))和與之年齡、性別相匹配的正常志愿者20例行靜息態(tài)fMRI掃描。經(jīng)ReHo, ALFF和fALFF分析獲得的靜息態(tài)數(shù)據(jù)分別進行全腦水平和雙側(cè)顳葉內(nèi)側(cè)水平兩樣本t檢驗分析；第二部分：對52例診斷為局灶性癲癇患者行常規(guī)MRI、VEEG、FDG-PET和RS-fMRI檢查的結(jié)果分別進行比較,統(tǒng)計分析這些技術(shù)定位致癇灶的敏感性、特異性、陽性預(yù)測值和陰性預(yù)測值差異,并對ReHo、ALFF及fALFF三種不同分析方法定位致癇灶的敏感性、特異性、陽性預(yù)測值和陰性預(yù)測值的差異進行統(tǒng)計分析。 結(jié)果： 1、ReHo、ALFF、fALFF三種分析方法均可以顯示左側(cè)顳葉內(nèi)側(cè)癲癇患者組局部異常的腦功能活動；患者組增加的異常腦活動區(qū)域主要位于左側(cè)顳葉內(nèi)側(cè)結(jié)構(gòu)和致癇灶同側(cè)腦區(qū)域。 2、經(jīng)卡方檢驗分析,分別比較MRI、VEEG、FDG-PET與RS-fMRI定位致癇灶敏感性、特異性、陽性預(yù)測值和陰性預(yù)測值的統(tǒng)計學(xué)差異。①MRI與RS-fMRI的診斷敏感性差異具有統(tǒng)計學(xué)意義,RS-fMRI敏感性高于MRI(x2值為8.60,P值為0.0034)。而VEEG、FDG-PET與RS-fMRI的診斷敏感性差異不具有統(tǒng)計學(xué)意義(P值均大于0.05)。②MRI、VEEG、FDG-PET與RS-fMRI的診斷特異性、陽性預(yù)測值和陰性預(yù)測值之間均無統(tǒng)計學(xué)意義(P值均大于0.05)。 3、經(jīng)卡方檢驗分析,比較ReHo、ALFF和fALFF三種分析方法定位致癇灶敏感性、特異性、陽性預(yù)測值和陰性預(yù)測值的統(tǒng)計學(xué)差異。①ReHo與ALFF和fALFF診斷敏感性差異具有統(tǒng)計學(xué)意義,ReHo的診斷敏感性高于ALFF和fALFF(x2值分別為4.63和8.82,P值分別為0.0314和0.0030),但ALFF和fALFF診斷敏感性差異不具有統(tǒng)計學(xué)意義(P值均大于0.05)。②ReHo、ALFF和fALFF三者之間的診斷特異性、陽性預(yù)測值和陰性預(yù)測值差異比較均無統(tǒng)計學(xué)意義(P值均大于0.05)。 結(jié)論： 1、基于ReHo、ALFF、fALFF分析方法的RS-fMRI具有較好的可行性,具有定位局灶性癲癇致癇灶和網(wǎng)絡(luò)的潛在能力。 2、基于ReHo、ALFF、fALFF的RS-fMRI具有相對高的敏感性和特異性定位致癇灶,與目前臨床領(lǐng)域常用的定位技術(shù)比較,其效能高于常規(guī)MRI,與VEEG和FDG-PET有相似的診斷效能,可用于臨床病例的研究。
[Abstract]:Objective: to investigate the feasibility of resting functional magnetic resonance imaging (Mr) based on Rehoff ALFF and fALFF in the diagnosis of epileptogenic foci caused by focal epilepsy, and to compare the diagnostic efficacy of MRIVEEG and FDG-PET with other techniques. Participants and methods: 52 cases of focal epilepsy diagnosed by clinical comprehensive diagnosis were selected. SIEMENS TRIO3.0T Mr scanner was used for routine MRI, hippocampal high-resolution imaging and resting fMRI scanning in all patients. The rest data were preprocessed by Matlab7.1 and SPM8. The data were preprocessed by REST1.4 software, ReHohaliff and fALFF. The analysis method processes to obtain the activation map, Then the results of the three methods were studied in two parts: group level and individual level. The first part: using REST1.4 software, 13 patients with unilateral medial temporal lobe epilepsy were treated with left side and 7 patients with right side. The images of 7 patients with right temporal lobe epilepsy were flipped) and aged. The rest state data obtained by Reho, ALFF and fALFF analysis were analyzed by t-test at global brain level and bilateral medial temporal lobe level, respectively. Part two: 52 patients with focal epilepsy were examined by conventional MRII-VEEGG-PET and RS-fMRI respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the epileptogenic foci were statistically analyzed. The sensitivity, specificity, positive predictive value and negative predictive value of epileptogenic foci were analyzed statistically. Results:. 1ReHoFFFFfALFF could show abnormal brain function in patients with left medial temporal lobe epilepsy, and the increased abnormal brain activity was mainly located in the medial structure of left temporal lobe and the ipsilateral brain region of epileptogenic foci. 2. The sensitivity and specificity of MRI VEEGG PET and RS-fMRI localization for epileptogenic foci were compared by chi-square test. The difference of diagnostic sensitivity between positive predictive value and negative predictive value was statistically significant. The sensitivity of RS-fMRI was higher than that of MRI(x2 (8.60% P = 0.0034), but there was no significant difference in diagnostic sensitivity between VEEGFDG-PET and RS-fMRI. The diagnostic specificity of VEEGG-PET and RS-fMRI was higher than 0.05%. There was no significant difference between the positive predictive value and the negative predictive value (P > 0.05). 3. The sensitivity and specificity of the three methods for localization of epileptogenic foci were compared between Rehoff and fALFF by chi-square test. The diagnostic sensitivity of ReHo was higher than that of ALFF and fALFF(x2 (4.63 and 8.82 P = 0.0314 and 0.0030, respectively), but the diagnostic sensitivity of ALFF and fALFF was higher than that of ALFF and fALFF. The difference between positive predictive value and negative predictive value was statistically significant. The diagnostic sensitivity of ReHo was higher than that of ALFF and fALFF(x2, respectively. The sex difference was not statistically significant (P > 0.05) and the diagnostic specificity between ReHoALFF and fALFF was significant. The difference between positive predictive value and negative predictive value was not statistically significant (P > 0.05). Conclusion:. 1. The RS-fMRI based on ReHoFFFfALFF analysis method is feasible and has the potential ability to locate focal epileptogenic foci and networks. 2. The RS-fMRI based on ReHoFFFfALFF has relatively high sensitivity and specificity in localization of epileptogenic foci. Compared with conventional localization techniques in clinical field, its efficacy is higher than that of conventional MRIs. It has similar diagnostic efficacy to VEEG and FDG-PET, and can be used in clinical case studies.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.2;R742.1

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本文編號：1515931