卒中后癫痫的静息态脑功能磁共振成像研究

本文探讨了静息态脑功能磁共振成像(rs-fMRI)检查在评价卒中后癫痫患者静息态脑功能改变中的应用价值。选择2017年5月~2019年5月我院收治的80例卒中后癫痫患者作为观察组,另选择同期健康体检者53例作为对照组。两组均完成rs-fMRI检查,采集相关数据,计算并比较两组被试全脑低频振幅(ALFF)值。分别以大脑(小脑)ALFF差异区作为种子区,计算并比较其与小脑(大脑)所有体素之间静息态功能连接(rsFC)。与对照组比较,卒中后癫痫患者右侧楔前叶、左侧额中回的ALFF明显升高,而右侧海马、右侧小脑脚2区、左侧小脑4/5区的ALFF明显降低(P<0.05)。以各大脑ALFF差异区(右侧海马、右侧楔前叶、左侧额中回)作为种子区域,卒中后癫痫患者依次对应在左侧小脑8区、右侧小脑4/5区的rsFC值明显升高(P<0.05);以各小脑ALFF差异区(右侧小脑脚2区、左侧小脑4/5区)作为种子区域,卒中后癫痫患者依次对应在左侧额下回、右侧颞中回的rsFC值明显降低(P<0.05)。结果表明,卒中后癫痫患者大脑和小脑之间多个脑区功能连通性发生改变,rs-fMRI检查可客观评价患者静息态脑功能变化,为患者的临床诊疗及预后评估提供影像学依据。

Resting Brain Functional Magnetic Resonance Imaging of Post-stroke Epilepsy

This paper discussed the application value of resting brain functional magnetic resonance imaging(rs-fMRI) in evaluating resting brain function changes in patients with post-stroke epilepsy.Eighty patients with post-stroke epilepsy admitted to our hospital from May 2017 to May 2019 were selected as the observation group,and 53 healthy people in the same period were selected as the control group.Both groups completed the rs-fMRI examination,we collected relevant data,calculated and compared the amplitude of low frequency fluctuations(ALFF)values of the whole brain of the two groups.The resting state functional connectivity(rsFC)between ALFF and all voxels in cerebellum(cerebellum)was calculated and compared.Compared with the control group,the ALFF in the right anterior cuneiform lobe and left middle frontal gyrus increased significantly,while ALFF in the right hippocampus,right cerebellar foot area 2 and left cerebellum area 4/5 decreased significantly in patients with post-stroke epilepsy(P<0.05).The ALFF differentially located areas(right hippocampus,right anterior cuneiform lobe and left middle frontal gyrus)were used as seed areas,the rsFC values in left cerebellum area 8 and right cerebellum area 4/5 were significantly increased in patients with post-stroke epilepsy(P<0.05).The seed regions were ALFF differential regions(right cerebellar foot 2 and left cerebellar 4/5),the rsFC values of the left inferior frontal gyrus and the right middle temporal gyrus were significantly lower in patients with post-stroke epilepsy(P<0.05).The results show that the functional connectivity of multiple brain areas between the brain and cerebellum of patients with post-stroke epilepsy has changed.rs-fMRI can objectively evaluate the changes of resting brain function of patients,and provide imaging basis for clinical diagnosis,treatment and prognosis evaluation.