影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (3): 441-446.DOI: 10.7517/issn.1674-0475.191007

• 综述与论文 • 上一篇    下一篇

rfMRI在首发原发性癫痫患者治疗效果评估中的应用

黄开平1,2, 王荣芬3, 刘云昇4   

  1. 1. 重庆医科大学附属儿童医院 放射科, 重庆 400014;
    2. 儿童发育疾病研究教育部重点实验室, 国家儿童健康与疾病临床医学研究中心, 儿童发育重大疾病国家国际科技合作基地, 儿科学重庆市重点实验室, 重庆 400014;
    3. 重庆市骨科医院 放射科, 重庆 400010;
    4. 重庆市垫江中医院 放射科, 重庆 408300
  • 收稿日期:2019-10-14 出版日期:2020-05-15 发布日期:2020-05-15
  • 通讯作者: 黄开平
  • 基金资助:
    重庆市基础与前沿研究计划项目(Y2016023222)资助

Application of rfMRI in the Evaluation of Treatment Effect in Patients with Primary Epilepsy

HUANG Kaiping1,2, WANG Rongfen3, LIU Yunsheng4   

  1. 1. Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing 400014, P. R China;
    2. The Ministry of Education Key laboratory of Child Development Disease Research, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P. R China;
    3. Department of Radiology, Chongqing Orthopaedic Hospital, Chongqing 400010, P. R China;
    4. Department of Radiology, Dianjiang Hospital of Traditional Chinese Medicine, Chongqing 408300, P. R China
  • Received:2019-10-14 Online:2020-05-15 Published:2020-05-15

摘要: 本文探讨了静息态功能磁共振成像(rfMRI)在首发原发性癫痫患者治疗效果评价中的应用。选取在2017年8月~2018年8月期间来我院诊治的首发原发性癫痫患者62例(观察组)和同期的健康志愿者(对照组)62例进行研究。两组受试者均进行rfMRI检查,观察组患者在进行为期3个月的药物治疗后再次行rfMRI检查。之后计算每例受试者的全脑比率低频振幅(fALFF)值,同时将观察组治疗前后的数据分别与对照组进行比较。结果显示,在治疗前,观察组患者的双侧丘脑、双侧后扣带回、左侧角会及左侧顶下小叶的fALFF值显著高于对照组(P<0.05);观察组的双侧前额叶及双侧前扣带回的fALFF值显著低于对照组(P<0.05)。在治疗后,与对照组相比,观察组双侧丘脑的异常激活脑区消失,双侧后扣带回、左侧角回的异常激活脑区的范围减少,然而左侧顶下小叶激活脑区的范围变大(P<0.05);观察组在治疗后,双侧额叶、双侧楔前叶及左侧楔叶的fALFF值显著高于对照组(P<0.05)。由此可知,rfMRI结合fALFF可以有效观察首发原发性癫痫患者在治疗前后的脑功能变化情况,同时也为临床药物治疗癫痫的疗效评估提供了参考。

关键词: 静息态功能磁共振成像, 原发性癫痫, 治疗效果

Abstract: In this paper, we investigated the application of resting-state functional magnetic resonance imaging(rfMRI) in the evaluation of the therapeutic effect of first-episode primary epilepsy patients. A total of 62 patients with primary epilepsy (observation group) and 62 healthy volunteers (control group) who came to our hospital from August 2017 to August 2018 were enrolled. The two groups were subjected to rfMRI examination, and the observation group patients were again subjected to rfMRI examination after a 3-month medical treatment. The whole brain ratio low frequency amplitude (fALFF) value of each subject was calculated, and the data of the observation group before and after treatment were compared with the control group. Before treatment, the fALFF values of bilateral thalamus, bilateral posterior cingulate gyrus, left anterior horn and left anterior lobule were significantly higher in the observation group than in the control group (P<0.05); the fALFF values of bilateral prefrontal lobe and bilateral anterior cingulate gyrus in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the abnormal activation of the bilateral thalamus areas in the observation group disappeared compared with the control group, and the range of abnormal activation of the bilateral posterior cingulate gyrus and left anterior gyrus in the observation group was reduced. However, the range of left parietal lobe activation brain area became larger (P<0.05). The fALFF values of the bilateral frontal lobe, bilateral anterior wedge and left wedge were significantly higher in the observation group than those in control group (P<0.05). The application of rfMRI combined with fALFF can effectively observe the changes of brain function in patients with primary epilepsy before and after treatment, and also provide a reference for the evaluation of clinical drug treatment for epilepsy.

Key words: resting-state functional magnetic resonance imaging(rfMRI), primary epilepsy, therapeutic effect