Study of the 1H-MRS in the Preoperative Localization of Temporal Lobe Epileptic Foci

doi:10.14033/j.cnki.cfmr.2016.19.002

Abstract：Objective:Comparative analysis of 1H-MRS and postoperative pathology in patients with TLE,to investigate the value of 1H-MRS in the diagnosis of TLE induced epileptic foci.Method:Preoperative conventional MRI and 1H-MRS were performed in 62 patients with clinically-diagnosed TLE,then analyzed the results of conventional MRI and the value of NAA/Cho、NAA/Cr、NAA/(Cho+Cr) of bilateral hippocampal area,t test was performed to compare the ratio of each metabolite in the hippocampus,and the changes of the metabolites in the hippocampus of TLE patients were compared and evaluated.NAA/(Cho+Cr) ratio was used as the reference value of TLE in the diagnosis,and the significance of 1H-MRS in the localization of epileptic foci in patients with TLE was evaluated.Conventional MRI,1H-MRS diagnostic results and postoperative pathological examination,line Kappa consistency test,comparative evaluation of routine MRI and TLE on the value of 1H-MRS in the localization of epileptic foci.Result:(1)Compared the NAA/Cho、NAA/Cr、NAA/(Cho+Cr) of the lateral hippocampal area and the contralateral hippocampus in the patients with TLE,there were significant differences(t=3.292,4.798,5.297,P<0.05).(2)Compared to postoperative pathology,the Kappa value of conventional MRI and 1H-MRS were 0.371,0.748,used the value of NAA/(Cho+Cr) 0.66 as the threshold,the sensitivity,specificity,positive predict value,negative predict value and accuracy of 1H-MRS for diagnosing hippocampal sclerosis were 95%,76%,91%, 87%and 89%,and conventional MRI respectively were 69%,70%,79%,57%and 69%.Conclusion:1H-MRS has higher value for localization of temporal lobe epileptic foci than MRI,combining with other techniques can further improve the accuracy and reliability of localizing the epileptic foci in patients with TLE.