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皮质发育畸形术前定位致痫灶的静息态功能MRI初步研究

赵博峰1,纪东旭1,杨卫东2,陈旨娟2,毓青3,蔡丽4,尹建忠1   

  1. 1. 天津医科大学一中心临床学院,天津市第一中心医院放射科
    2. 天津医科大学总医院神经外科
    3. 天津医科大学总医院神经内科
    4. 天津医科大学总医院PET-CT中心
  • 收稿日期:2014-04-11 修回日期:2014-05-15 出版日期:2014-11-15 发布日期:2014-11-15
  • 通讯作者: 尹建忠

A Plot Study of Resting State-fMRI: Preoperative Localization of Epileptogenic Zone in Epilepsy with Malformations of Cortical Development

ZHAO Bo feng1,JI Dong xu1,YANG Wei dong2,CHEN Zhi juan2,YU Qing 3,CAI Li 4,YIN Jian zhong1   

  1. 1. First Center Clinic College, Tianjin Medical University,Department of Radiology, Tianjin FirstCentral Hospital
    2. Department of Neurosurgery
    3. Department of Neurology
    4. PET/CT Center, General Hospital of Tianjin Medical University
  • Received:2014-04-11 Revised:2014-05-15 Published:2014-11-15 Online:2014-11-15
  • Contact: YIN Jian zhong

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摘要：

【 摘要】 目的 探讨基于局部一致性（ReHo）、低频振幅（ALFF）和低频振幅分数（fALFF）的静息态功能 MRI（RS-fMRI）是否具有术前定位皮质发育畸形（MCD）患者致 灶的能力。 方法 MCD 患者 10 例行 RS-fMRI 检查， 静息态数据经预处理和分析后得到的 ReHo、ALFF 和 fALFF 激活图， 与视频脑电图（VEEG）、正电子发射断层显像（PET）、MRI 及综合评估的致 灶结果比较。 比较患者术后结果与静息态异常激活图结果。 结果 RS-fMRI 致 灶定位结果分别与 6 例 VEEG、8 例 PET、6 例 MRI 以及 7 例最终综合评估的致 灶定位结果一致。 6 例接受手术治疗的患者（包括 2 例 MRI 检查阴性）均发现异常的局部激活图， 术后经病理证实为皮质发育畸形（2 例灰质异位和 4 例
局灶性皮质发育不良）。 结论 基于 ReHo、ALFF 及 fALFF 分析方法的 RS-fMRI 具有定位 MCD 患者致 灶的能力。

关键词: 皮质发育畸形, 磁共振成像, 脑电描记术, 正电子发射断层显像术, 静息态磁共振脑功能成像, 局部一致性, 低频振幅, 低频振幅分数

Abstract:

[Abstract]   Objective   To investigate whether resting state-fMRI (RS-fMRI) based on local consistency (ReHo), am?plitude low-frequency fluctuate (ALFF) and fALFF can add meaningful information on preoperative localization of epileptogenic zone in patients with malformations of cortical development (MCD).   Method  Ten epilepsy patients with MCD were studied with RS-fMRI using a 3.0 T scanner. The resting state data were preprocessed and analyzed using SPM8 and REST to generate the activation map. Abnormal ReHo, ALFF and fALFF related blood oxygen level dependent (BOLD) signal changes were compared to video EEG (VEEG)， PET， MRI findings and the final result of a comprehensive evaluation-defined epileptogenic zone. For operated patients, postoperative resection and histology were compared to BOLD responses. Results The results of spike localization of RS-fMRI were consistent with VEEG, PET, MRI findings and final comprehensive evaluation-defined epileptogenic zone in 6, 8, 6, 7 of 10 investigations. Six operated patients (including two negative results of MRI examination) revealed local abnormal changes but not visible on structural MRI, which was confirmed cortical malfor?mations by pathology after operation (2 heterotopia and 4 cortical dysplasia).   Conclusion   RS-fMRI may help to delineate the epileptic focus in epilepsy patients with MCD.

Key words: malformations of cortical development, electroencephalography, Positron-Emission Tomography, Resting state-fMRI, Regional homogeneity, Amplitude of low-frequency fluctuation, fractional of ALFF, 低频振幅分数