本文選題：局灶性癲癇 + 腦電聯(lián)合功能磁共振成像��； 參考：《南京大學(xué)》2014年碩士論文

【摘要】：目的：對(duì)比低頻振幅(ALFF)分析技術(shù)與腦電聯(lián)合功能磁共振成像(EEG-fMRI)技術(shù)對(duì)局灶性癲癇活動(dòng)檢測(cè)的能力,評(píng)估ALFF分析技術(shù)在局灶性癲癇活動(dòng)定位中的應(yīng)用價(jià)值。資料和方法：24例有明確病理灶存在的局灶性癲癇患者納入,分別于GE1.5TMRI儀(17例)及Siemens 3.0T MRI儀(7例)下行同步EEG-fMRI數(shù)據(jù)采集。以廣義線性模型(GLM)方法對(duì)間期癇樣發(fā)放(IEDs)相關(guān)fMRI活動(dòng)的檢測(cè)為基礎(chǔ)；再采用ALFF分析技術(shù),使用個(gè)例患者與大樣本正常受試者基線數(shù)據(jù)進(jìn)行兩樣本t檢驗(yàn)(P0.05,Alphasim校正),檢測(cè)局灶性癲癇腦區(qū)ALFF改變的位置。最后以臨床或手術(shù)癲癇定位結(jié)果為標(biāo)準(zhǔn),對(duì)比分析兩種fMRI技術(shù)對(duì)癲癇活動(dòng)的檢測(cè)能力。結(jié)果：在36次有效癲癇EEG-fMRI數(shù)據(jù)中,兩種分析技術(shù)均有明顯的BOLD結(jié)果檢出。EEG-fMRI定位結(jié)果與臨床定位結(jié)果相關(guān)者15次(15/36,41.66%)；ALFF結(jié)果與臨床定位結(jié)果相關(guān)者24次(24/36,66.66%)。兩者定位結(jié)果一致且均與臨床定位結(jié)果相關(guān)者9次(9/36,25.00%),兩者定位結(jié)果均與臨床定位結(jié)果不符者6次(6/36,16.67%)。結(jié)論：EEG-fMRI能有效地檢出癲癇活動(dòng)相關(guān)腦區(qū)；基于ALFF的fMRI技術(shù)則可在不需同步EEG信息的情況下,取得更好的癲癇活動(dòng)檢測(cè)效果,為癲癇活動(dòng)定位提供了一種新的fMRI分析技術(shù)。目的：觀測(cè)ALFF和功能連接在內(nèi)側(cè)顳葉癲癇中相反的改變模式,評(píng)估兩種方法的聯(lián)合應(yīng)用在癲癇活動(dòng)檢測(cè)中的應(yīng)用價(jià)值。資料和方法：采集47例內(nèi)側(cè)顥葉癲癇患者與32名正常志愿者靜息態(tài)fMRI數(shù)據(jù),患者組同步采集EEG數(shù)據(jù)且在采集期間均檢測(cè)到間期癇樣放電。ALFF、FCD數(shù)據(jù)預(yù)處理后進(jìn)行相關(guān)標(biāo)準(zhǔn)化運(yùn)算得到ALFF-FCD對(duì)比腦圖,通過(guò)兩樣本t檢驗(yàn)分別觀察mTLE患者相對(duì)正常對(duì)照組ALFF、FCD及ALFF-FCD的改變腦區(qū)；左、右側(cè)mTLE患者選取相應(yīng)的左右內(nèi)側(cè)顳葉為ROI,采用二分法/ROC曲線方式評(píng)估三種成像方法的定側(cè)效能；最后采用相關(guān)分析觀察mTLE患者FCD、ALFF及ALFF-FCD改變腦區(qū)與間期癇樣放電數(shù)目及癲癇病程的關(guān)系。結(jié)果：與正常對(duì)照組相比,mTLE患者發(fā)作間期ALFF增加區(qū)與FCD減低區(qū)均主要分布于損傷側(cè)的顳區(qū),而DMN腦區(qū)在兩種方法中均呈減低改變。ALFF-FCD聯(lián)合使用較單獨(dú)任一種方法能更有效的區(qū)分mTLE患者與正常被試(區(qū)分L-mTLE與HC的準(zhǔn)確度為0.95,R-mTLE與HC中為0.92)。基于體素的相關(guān)分析顯示,間期癇樣放電數(shù)目在內(nèi)側(cè)顳葉與ALFF呈正相關(guān),與FCD呈負(fù)相關(guān),后扣帶回和頂葉與ALFF和FCD均呈負(fù)相關(guān)；病程在內(nèi)側(cè)顳葉,后扣帶回及頂葉與ALFF和FCD均呈負(fù)相關(guān),頂葉與ALFF-FCD結(jié)果呈正相關(guān)(P0.05,FDR校正)。結(jié)論：mTLE相關(guān)腦區(qū)振幅及功能連接的不匹配性改變可以增加癲癇活動(dòng)的檢測(cè)效能,癲癇慢性損傷在ALFF和FCD中均能引起DMN的降低。綜合多個(gè)成像方法有助于深入探究癲癇的病理生理機(jī)制。
[Abstract]:Objective: To compare the ability of low-frequency amplitude (ALFF) analysis and EEG combined functional magnetic resonance imaging (EEG-fMRI) to detect focal epileptic activity and evaluate the value of ALFF analysis in the localization of focal epileptic activities. Data and methods: 24 cases of focal epileptic patients with clear foci were included in GE1., respectively, in GE1. 5TMRI (17 cases) and Siemens 3.0T MRI (7 cases) synchronous EEG-fMRI data acquisition. Based on the generalized linear model (GLM) method for the detection of fMRI activity associated with interphase epileptiform (IEDs), and ALFF analysis technique, a two sample t test (P0.05, Alphasim correction) is used in a case patient and a large sample of normal subjects. The location of ALFF changes in the focal epileptic region of the focal epilepsy was detected. Finally, the detection ability of two fMRI techniques for epileptic activity was compared with the results of clinical or surgical epileptic localization. Results: in the 36 effective epileptic EEG-fMRI data, the two analysis techniques had obvious BOLD results to detect the results of.EEG-fMRI localization and the clinical location results. 15 times (15/36,41.66%) and 24 times (24/36,66.66%) related to the results of clinical localization. The results were consistent and 9 times (9/36,25.00%) related to the clinical location results. The results of both localization and clinical localization were all 6 times (6/36,16.67%). Conclusion: EEG-fMRI can effectively detect the brain area of epileptic activity. ALFF based fMRI technology can achieve better epileptic activity detection effect without synchronization of EEG information, and provide a new fMRI analysis technique for epileptic location. Objective: To observe the reverse pattern of ALFF and functional connection in the medial temporal lobe epilepsy, and evaluate the combined application of two methods in epileptic activity detection. Data and methods: data and methods: the resting state fMRI data of 47 cases of medial temporal lobe epilepsy and 32 normal volunteers were collected. The patient group collected the EEG data synchronously and detected the interphase epileptiform discharge.ALFF during the acquisition period, and the correlation standardized operation was performed after the FCD data preprocessing to obtain the ALFF-FCD contrast brain map and the t test of two samples. The mTLE patients were compared with the normal control group ALFF, FCD and ALFF-FCD to change the brain region. The left and right mTLE patients selected the corresponding left and right medial temporal lobe to ROI, using the dichotomous /ROC curve to evaluate the lateral efficacy of the three imaging methods. Finally, the correlation analysis was used to observe the FCD in mTLE patients, ALFF and ALFF-FCD to change the brain area and interphase epileptiform. The relationship between the number of discharge and the course of epilepsy. Results: compared with the normal control group, both the ALFF increasing area and the FCD reduction area of the mTLE patients were mainly distributed in the temporal region of the injured side, while the DMN brain region was reduced in the two methods, and the combination of the.ALFF-FCD and the mTLE could be more effective to distinguish between the mTLE and the normal subjects. The accuracy of L-mTLE and HC was 0.95 and 0.92 in R-mTLE and HC. The correlation analysis based on voxel showed that the number of intertemporal epileptiform discharges was positively correlated with ALFF and negatively correlated with FCD. The posterior cingulate gyrus and parietal lobe were negatively correlated with ALFF and FCD, and the course was in the medial temporal lobe, and the posterior cingulate gyrus and parietal lobe were negatively related to ALFF and FCD, top. There is a positive correlation between the leaves and the results of ALFF-FCD (P0.05, FDR correction). Conclusion: the amplitude of mTLE related brain region and the mismatch of functional connection can increase the detection efficiency of epileptic activity. The chronic epileptic injury can cause the decrease of DMN in ALFF and FCD. Comprehensive multiple imaging methods are helpful to explore the pathophysiological mechanism of epilepsy in depth.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.2;R742.1

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