本文選題：顳葉癲癇　切入點：靜息態(tài)　出處：《福建醫(yī)科大學》2014年碩士論文

【摘要】：目的 本研究聯(lián)合動態(tài)磁敏感對比增強(dynamic susceptibility contrast-enhanced, DSC)灌注成像、動脈自旋標記(arterial spin labeling, ASL)技術及基于局部一致性分析方法的靜息態(tài)功能磁共振成像,探討顳葉癲癇(temporal lobe epilepsy,TLE)發(fā)作間期內側顳葉的灌注改變及靜息狀態(tài)下腦功能變化特點。 材料與方法 采用西門子3.0T Trio Tim磁共振掃描儀對經(jīng)過手術病理證實的15例發(fā)作間期右利手TLE患者及相匹配15例正常對照者行DSC、ASL掃描和靜息態(tài)BOLD-fMRI檢查。在工作站上重建出DSC的相對腦血容量(relative cerebral blood volume, rCBV)圖及相對腦血流量(relative cerebral blood flow, rCBF)圖,結合高分辨率解剖像,選取兩側內側顳葉作為感興趣區(qū)(region of interest, ROI),計算病例組及正常對照組兩側內側顳葉的rCBV值、rCBF值,比較病例組及正常對照組兩側內側顳葉rCBV、rCBF的不對稱指數(shù)(asymmetry index, AI)的差異。應用Matlab7.8、SPM8軟件包對ASL自動生成的rCBF圖進行空間預處理和分析,得到并比較病例組和正常對照組間灌注差異的偽彩圖。應用Matlab7.8、SPM8、 DPARSF和REST軟件包對Resting state-fMRI圖像進行數(shù)據(jù)預處理,采用局部一致性(Regional Homogeneity, ReHo)分析方法,比較病例組和正常對照組平均腦ReHo圖的差異；提取兩組被試兩側內側顳葉的ReHo值,并比較兩側的差異。 結果 1、正常對照組雙側內側顳葉rCBV值、rCBF值無顯著性差異(P0.05)。TLE組患側rCBV值、rCBF值均低于對側(P0.05)。TLE組AIrCBV、AIrCBF均高于正常對照組(P0.05)。 2、TLE患者內側顳葉AIrCBF值、AIrCBV值均與病程呈正相關。 3、與正常對照組相比,TLE組ReHo值減低的腦區(qū)包括：右側小腦后葉、左側顳下回、左側顳中回、左側海馬、胼胝體、丘腦、右側楔前葉、左側頂下小葉、左側額中回及內側額回,差異有統(tǒng)計學意義(P0.05)；而腦干、右側中央前回、前扣帶回、左側海馬旁回、左側顳上回及右側海馬旁回的ReHo值明顯升高,差異有統(tǒng)計學意義(P0.05)。正常對照組雙側內側顳葉ReHo值無顯著性差異(P0.05),TLE組患側內側顳葉ReHo值低于對側,差異有統(tǒng)計學意義(P0.05)。 結論 1、TLE發(fā)作間期患側內側顳葉rCBV值、rCBF值降低； 2、TLE發(fā)作間期靜息狀態(tài)下存在廣泛的腦功能異常； 3、局部一致性分析方法可檢出癲癇活動造成的局部腦組織血氧水平依賴信號同步性的改變,從而有助于癲癇病理生理機制的探索。
[Abstract]:PurposeIn this study, dynamic susceptibility contrast-enhanced perfusion imaging, arterial spin-labeled arterial spin labeling and resting functional magnetic resonance imaging based on local consistency analysis were studied.To investigate the changes of perfusion in the medial temporal lobe during the interictal phase of temporal lobe epilepsy and the changes of brain function in resting state.Materials and methods15 patients with interictal right-handed-hand TLE and 15 matched normal controls were examined by Siemens 3.0T Trio Tim magnetic resonance scanner (DSC-ASL) and rest BOLD-fMRI.The relative cerebral blood volume (rCBV) of DSC and the relative cerebral blood flow (rCBFV) of relative cerebral blood flow were reconstructed on workstation.Using bilateral medial temporal lobe as region of interest (ROI), the rCBV values of bilateral medial temporal lobes were calculated in case group and normal control group. The asymmetry index (asymmetric index) of rCBV rCBF was compared between the case group and the normal control group.The rCBF map automatically generated by ASL was preprocessed and analyzed by Matlab 7.8 SPM8 software package, and the pseudo-color images of perfusion difference between the case group and the normal control group were obtained and compared.Matlab-7.8 SPM8, DPARSF and REST software package were used to preprocess the data of Resting state-fMRI images, and the regional homogenicity (ReHoA) analysis method was used to compare the differences between the average ReHo map of brain in the case group and the normal control group, and to extract the ReHo values of the medial temporal lobes of the two groups.And compare the differences between the two sides.Result1. There was no significant difference in the rCBV value of bilateral medial temporal lobes in the normal control group. The rCBV value of the affected side in the TLE group was lower than that in the control group (P 0.05). The AIRCBF in the TLE group was higher than that in the normal control group (P 0.05).2 the AIrCBF value of medial temporal lobe and AIrCBV were positively correlated with the course of TLE.3Compared with the normal control group, the ReHo decreased in the right posterior cerebellar lobe, left inferior temporal gyrus, left middle temporal gyrus, left hippocampus, corpus callosum, thalamus, right anterior cuneate lobe, left inferior parietal lobule, left middle frontal gyrus and medial frontal gyrus.The difference was statistically significant (P 0.05), while the ReHo values of the right precentral gyrus, anterior cingulate gyrus, left parahippocampal gyrus, left superior temporal gyrus and right parahippocampal gyrus were significantly increased in the brain stem, and the difference was statistically significant (P 0.05).There was no significant difference in ReHo value of bilateral medial temporal lobe in normal control group. The ReHo value of medial temporal lobe in TLE group was lower than that in contralateral side, and the difference was statistically significant (P 0.05).Conclusion1the rCBV value and rCBF value of medial temporal lobe decreased in the interictal stage of TLE.(2) there were extensive brain dysfunction in the resting state of TLE during interictal period;3. The method of local consistency analysis can detect the synchronous changes of blood oxygen level of local brain tissue caused by epileptic activity, which is helpful to explore the pathophysiological mechanism of epilepsy.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R742.1;R445.2

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本文編號：1713986