| 张晓楠,宋承汝,马可燃,毛鑫月,张勇.神经突方向离散度和密度成像诊断单侧颞叶癫痫伴海马硬化[J].中国医学影像技术,2025,41(9):1477~1482 |
| 神经突方向离散度和密度成像诊断单侧颞叶癫痫伴海马硬化 |
| Neurite orientation dispersion and density imaging for diagnosing unilateral temporal lobe epilepsy complicated with hippocampal sclerosis |
| 投稿时间：2025-03-08 修订日期：2025-09-10 |
| DOI：10.13929/j.issn.1003-3289.2025.09.005 |
| 中文关键词: 癫痫,颞叶|海马硬化|磁共振成像|前瞻性研究 |
| 英文关键词:epilepsy, temporal lobe|hippocampal sclerosis|magnetic resonance imaging|prospective studies |
| 基金项目:国家自然科学基金(82471962)、河南省医学教育研究项目(WJLX2023033)。 |
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| 中文摘要: |
| 目的 观察神经突方向离散度和密度成像(NODDI)用于诊断单侧颞叶癫痫(TLE)伴海马硬化(HS)(TLE-HS)的价值。方法 前瞻性对55例单侧TLE-HS(TLE-HS组)及55名健康对照(HC组)采集颅脑弥散峰度成像(DKI)、3D T1WI和3D液体衰减反转恢复(FLAIR)序列图像并获得NODDI参数图;比较TLE-HS组患侧、健侧及HC组及两两间海马NODDI参数和FLAIR信号强度,分析其诊断单侧TLE-HS的价值。结果 TLE-HS组患侧、健侧及HC组海马细胞内体积分数(ICVF)、各向同性体积分数(ISOVF)、取向分散指数(ODI)值及FLAIR信号强度差异均有统计学意义(P均＜0.05);其中,TLE-HS组患侧与健侧海马ICVF、ISOVF及ODI值差异有统计学意义(P均＜0.05),TLE-HS组患侧与HC组ICVF、ISOVF、ODI值及FLAIR信号强度差异均有统计学意义(P均＜0.05),TLE-HS组健侧与HC组ISOVF值及FLAIR信号强度差异有统计学意义(P均＜0.05)。ICVF、ISOVF、ODI及三者联合用于鉴别TLE-HS患者患侧与健侧海马的曲线下面积(AUC)分别为0.913、0.712、0.912及0.964,鉴别TLE-HS患侧与HC的AUC分别为0.940、0.822、0.871及0.971,均以三者联合AUC最高(P均＜0.05);ISOVF、ODI及二者联合用于鉴别TLE-HS健侧与HC海马的AUC分别为0.666、0.630及0.744,差异均无统计学意义(P均＞0.05)。FLAIR信号强度用于鉴别TLE-HS患者患侧与健侧、TLE-HS患侧与HC及TLE-HS健侧与HC海马的AUC分别为0.627、0.756及0.653。结论 双侧海马NODDI参数均有助于诊断单侧TLE-HS,且可能优于目前常用FLAIR序列。 |
| 英文摘要: |
| Objective To observe the value of neurite orientation dispersion and density imaging (NODDI) for diagnosing unilateral temporal lobe epilepsy (TLE) complicated with hippocampal sclerosis (HS) (TLE-HS). Methods Brain diffusion kurtosis imaging (DKI), 3D T1WI and 3D fluid attenuated inversion recovery (FLAIR) sequence images were prospectively collected in 55 patients with unilateral TLE-HS (TLE-HS group) and 55 healthy controls (HC group), and NODDI parameter maps were acquired. The hippocampus NODDI parameters values and FLAIR signal intensity were compared among the affected side, the healthy side in TLE-HS group and HC group, as well as between each two, and their value for diagnosing unilateral TLE-HS were analyzed. Results Significant differences of hippocampus intracellular volume fraction (ICVF), isotropic volume fraction (ISOVF), orientation dispersion index (ODI) values and FLAIR signal intensity were found among the affected side, the healthy side in TLE-HS group and HC group (all P＜0.05). There were significant differences of ICVF, ISOVF and ODI values between the affected side and the healthy side in TLE-HS group (all P＜0.05), of ICVF, ISOVF, ODI values and FLAIR signal intensity between the affected side in TLE-HS group and HC group (all P＜0.05), and of ISOVF values and FLAIR signal intensity between the healthy side in TLE-HS group and HC group (both P＜0.05). The area under the curve (AUC) of ICVF, ISOVF, ODI and their combination for differentiating the affected side and the healthy side of TLE-HS was 0.913, 0.712, 0.912 and 0.964, for differentiating the affected side of TLE-HS and HC was 0.940, 0.822, 0.871 and 0.971, respectively, and the combination both had the highest AUC (both P＜0.05). The AUC of ISOVF, ODI and their combination for differentiating the healthy side of TLE-HS and HC was 0.666, 0.630 and 0.744, respectively, being not significant different (all P＞0.05). The AUC of FLAIR signal intensity for differentiating the affected side and the healthy side of TLE-HS, the affected side of TLE-HS and HC, the healthy side of TLE-HS and HC was 0.627, 0.756 and 0.653, respectively. Conclusion Bilateral hippocampus NODDI parameters were helpful for diagnosing unilateral TLE-HS, which might be superior to commonly used FLAIR sequence. |
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