| Objective:To analyze proton Magnetic Resonance Spectroscopy (1HMRS) characteristics of temporal lobe epilepsy with routine MR hippocampal sclerosis and negative, and investigate the value of 1HMRS in the early diagnosis of hippocampal sclerosis and lateralization of epileptogenic focus, the correlation between 1HMRS and the total of seizure.Methods:30 outpatients and inpatients with temporal lobe epilepsy were collected from September 2010 to March 2011 in Epilepsy Center of our hospital,with a detailed record of all clinical data.All of cases underwent EEG, routine MRI.The above 30 patients and 10 control subjects underwent'HMRS examination to observe characteristics of NAA, Cr, Cho peaks, and calculate NAA/Cr+Cho ratio.(1)Decide the focus according to routine MRI, EEG,symptom and'HMRS, and contrast the result of EEG and'HMRS.(2)A11 of case were divided into the hippocampal sclerosis group and hippocampal-negative group according to routine MRI. one-way analysis of variance (ANOVA) was applied to respectively compare the NAA/Cr+ Cho ratio of the focus and the opposite of two groups and the normal. Two independent samples t-test was applied to compare the NAA/Cr+Cho ratio of the focus of two groups.(3) To analysis the relevance of ipsilateral hippocampal NAA/Cr+Cho ratio and the total of seizure with the spearmen.Results:(1) In 30 patients with temporal lobe epilepsy, EEG and 1HMRS respectively found the focus in 21 cases and 24 cases,the positive rate was respectively of 70% and 80%. with combination of two methods, the positive rate can be increase to 96.7%. (2) The NAA/Cr+Cho ratio of the focus and the opposite of hippocampal sclerosis group were lower than the normal,reduction of the focus were more obvious. The NAA/Cr+Cho ratio of the focus of hippocampal negative group was lower than the normal, but no significant difference between the opposite and the normal.The lower of the focus of hippocampal sclerosis group than hippocampal negative group had significant difference.(3) The NAA/Cr+Cho ratio of the focus was negatively correlated with the total of seizure (r=-0.687,p<0.05).Conclusion:(1)1HMRS is valuable in lateralization of temporal lobe epilepsy, the positive rate was higher than the one EEG, combination of two methods may increase the positive rate. (2) 1HMRS can detect metabolic abnormalities in temporal lobe epilepsy with MRI-negative, and increases the sensitivity of diagnosis of hippocampal sclerosis.(3)1HMRS may be able to be used quantitative analysis of clinical severity of temporal lobe epilepsy. |
