本文選題：癲癇　切入點(diǎn)：特發(fā)性　出處：《遵義醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的：應(yīng)用FreeSurfer軟件基于腦表面形態(tài)學(xué)的分析方法，初步研究特發(fā)性全面性癲癇患者腦皮層形態(tài)學(xué)（全腦皮層厚度、表面面積、體積）的微觀結(jié)構(gòu)改變，探討這種新技術(shù)對(duì)特發(fā)性全面性癲癇的應(yīng)用價(jià)值，并分析異常腦區(qū)與臨床變量（病程、發(fā)病起始年齡）的相關(guān)性。 方法：收集2011年3月至2013年9月遵義醫(yī)學(xué)院附屬醫(yī)院門診及住院特發(fā)性全面性癲癇患者16例（經(jīng)高年資神經(jīng)內(nèi)科及兒科醫(yī)師按照2005年國(guó)際抗癲癇聯(lián)盟診斷癲癇和癲癇綜合征的標(biāo)準(zhǔn)進(jìn)行篩選），男6例，，女10例，同時(shí)招募16例健康志愿者作為對(duì)照組，兩組性別、年齡、教育程度及利手相匹配。所有受試對(duì)象采用西門子公司3.0T Trio A Tim超導(dǎo)MR掃描儀進(jìn)行常規(guī)序列和高分辨率3D-T1WI結(jié)構(gòu)像。皮層厚度、表面面積及體積的分析采用FreeSurer軟件，采用一般線性模型進(jìn)行分析；年齡及性別作為協(xié)變量，設(shè)P0.05為兩組差異腦區(qū)有統(tǒng)計(jì)學(xué)意義。采用SPSS17.0軟件分析異常腦區(qū)與臨床變量（病程及發(fā)病起始年齡）的相關(guān)性。本實(shí)驗(yàn)得到遵義醫(yī)學(xué)院倫理委員會(huì)的批準(zhǔn)，受試者均被告知相應(yīng)的權(quán)利和義務(wù)，并征得本人及家屬同意并簽署參與研究的知情同意書。 結(jié)果：患者組與對(duì)照組性別、年齡、受教育程度均無(wú)統(tǒng)計(jì)學(xué)差異（P值分別為1.000、0.960、0.084）。與正常對(duì)照組相比，患者組腦形態(tài)學(xué)改變?yōu)椋河绎D中回皮層變薄（P=0.0109），左腦未見異常腦區(qū)。左顳中回表面積減�。≒=0.0003）；左額下回中部（P=0.0002）、左外側(cè)枕葉（P=0.0436）、右島葉（P=0.0007）表面積增大；左顳上回（P=0.0119）體積減小，右大腦體積未見異常腦區(qū)。上述異常腦區(qū)與患者病程、發(fā)病起始年齡無(wú)相關(guān)性（P0.05）。其中，皮層厚度異常腦區(qū)（右顳中回）與病程的相關(guān)分析P值（P=0.06）接近于0.05。 結(jié)論：本研究發(fā)現(xiàn)IGE皮層厚度、表面面積及體積多個(gè)腦區(qū)異常，反映了IGE的微觀結(jié)構(gòu)形態(tài)學(xué)的變化，為IGE潛在的神經(jīng)病理、解剖學(xué)的變化以及病理生理機(jī)制的理解提供影像學(xué)依據(jù)。
[Abstract]:Objective: to study the microstructural changes of cerebral cortex morphology (whole cerebral cortex thickness, surface area, volume) in patients with idiopathic comprehensive epilepsy using FreeSurfer software.To explore the application value of this new technique in idiopathic comprehensive epilepsy, and to analyze the correlation between abnormal brain area and clinical variables (course of disease, onset age of onset).Methods: from March 2011 to September 2013, 16 patients with idiopathic comprehensive epilepsy were collected from the affiliated Hospital of Zunyi Medical College.The criteria for epilepsy syndrome were selected, 6 cases of male, 6 cases of epileptic syndrome,Ten women and 16 healthy volunteers were recruited as control group. The sex, age, education level and handy hand of the two groups were matched.All subjects were examined by Siemens 3.0T Trio A Tim superconducting Mr scanner for conventional sequences and high-resolution 3D-T1WI structure images.The cortical thickness, surface area and volume were analyzed by FreeSurer software and general linear model. Age and sex were covariables.The correlation between abnormal brain area and clinical variables (course of disease and onset age) was analyzed by SPSS17.0 software.This experiment was approved by the Ethics Committee of Zunyi Medical College. The subjects were informed of their rights and obligations and signed the informed consent to participate in the study with the consent of themselves and their families.Results: there was no significant difference in sex, age and education level between the patients group and the control group (P = 1.0000.960,0.084).Compared with the normal control group, the morphologic changes of the brain in the patients group were as follows: the cortex of the right middle temporal gyrus was thinning and the left brain was not abnormal.The surface area of left middle temporal gyrus decreased (P = 0.0003), while that of left inferior frontal gyrus was 0.0002, and that of left lateral occipital lobe was increased (P = 0.0436, P = 0.0007), and the volume of left superior temporal gyrus (P = 0.0119) was decreased, and no abnormal brain area was found in right cerebrum.There was no correlation between the above abnormal brain area and the course of disease and onset age (P 0.05).The correlation between abnormal cortical thickness (right middle temporal gyrus) and course of disease (P = 0.06) was close to 0.05.Conclusion: in this study, the cortical thickness, surface area and volume of IGE were found to be abnormal, which reflected the microstructural and morphological changes of IGE and was a potential neuropathology of IGE.Anatomical changes and understanding of pathophysiological mechanisms provide imaging evidence.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742.1

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