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双语推荐:颞叶

目的:探讨难治性颞叶癫痫海马硬化(HS)与同侧前颞叶 MRI特征及其与临床的相关性。方法:搜集经影像学或病理诊断为难治性颞叶癫痫 HS的34例患者的临床和影像资料,其中25例行手术治疗。34例中女15例,男19例,平均年龄(22.4±8.2)岁。观察海马及同侧前颞叶 MRI征象,根据海马及前颞叶 MRI 征象将34例分为同侧前颞叶正常组与前颞叶异常组,后者再分为同时出现灰白质分界模糊和颞叶萎缩组与仅出现一种征象组两亚组,比较各组间临床特征的差异。结果:34例中,22例(64.7%)出现 HS及同侧前颞叶异常,12例同侧颞叶正常。前颞叶异常组首次癫痫发作年龄低于前颞叶正常组(t=-3.438,P=0.002),病程时间比前颞叶正常组长(t=2.453,P=0.020)。前颞叶同时出现灰白质分界模糊和颞叶萎缩组与仅存在一种征象组间临床特征无统计学差异。结论:难治性颞叶癫痫伴有前颞叶异常的颞叶癫痫多数首次发病年龄小,病程长,MRI特征与临床病情具有紧密的相关性,对于手术侧别选择意义重大。
Objective:To investigate the MRI features of hippocampal sclerosis (HS)with ipsilateral anterior tempo-ral abnormality and correlation between which and clinical manifestation in refractory temporal lobe epilepsy (TLE).Meth-ods:34 patients with TLE including 15 females and 19 males,aged (22.4±8.2)years were included,and all patients were diagnosed with HS by pathology and/or MRI.25 patients underwent surgical treatment and pathological diagnosis was ob-tained.MRI changes of hippocampus and ipsilateral anterior temporal lobe abnormalities were observed.All patients were divided into two groups according to the presence/absence of MRI signs indicative of anterior temporal abnormality.The group of ipsilateral anterior temporal abnormality was divided into two subgroups on the basis of whether grey/white matter blurring and temporal lobe atrophy were present concomitantly or not.The clinical features were compared between the two groups and two subgroups respectively.Results:Of

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目的 总结我国右侧颞叶变异型语义性痴呆的临床特征,通过与左侧颞叶萎缩的语义性痴呆对比,了解功能与解剖的联系.方法 我院认知障碍门诊诊断的70例额颞叶变性患者,根据头颅MRI确认右侧颞叶萎缩患者3例,以5例左侧颞叶萎缩的语义性痴呆患者做对照,比较其认知、行为和人格特征.并对3例右侧颞叶萎缩患者进行头颅18氟-氟代脱氧葡萄糖-正电子发射计算机断层扫描(18F-FDG-PET)及统计参数图分析.结果 右侧颞叶萎缩以面容失认、导航能力受损更常见,早期缄默、脱抑制、固执和强迫等多种行为异常发生率高,不同于左侧语义性痴呆的早期命名和单个词的理解障碍.18F-FDG-PET均显示右侧颞叶代谢减低,极明显,伴有不同程度其他脑区受损.结论右侧颞叶萎缩具有很大的临床异质性,以早期的面容失认、行为改变、导航能力障碍为主要特征,可能是一种独立的临床实体.
Objective To identify the clinical profile and neuro-imaging findings of the right temporal lobe variant of semantic dementia (RTLV),and to understand the relationship between anatomic and function by comparison to the left temporal lobe atrophy.Methods Of 70 patients with diagnosis of frontotemporal dementia in our memory clinic,three patients with right temporal lobe atrophy were identified based on the MRI scans.We obtained the profile of cognitive function,behavior and personality changes in these 3 patients and compared them with those in 5 semantic dementia (SD) patients with predominant leftsided temporal lobe atrophy.We also underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) with statistical parametric mapping analysis in these 3 patients.Results In RTLV patients,the most prominent cognitive deficits were impairment of prosopagnosia,and getting lost.Variety behavioral symptoms including apathy,social disinhibition,stereotypy,compulsive behaviors w

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目的探讨影响颅脑损伤患者精神障碍的相关因素。方法选择在我院救治的创伤性颅脑损伤患者336例为调查对象,采用一般资料问卷、智商、记忆商测试以及SCID-1/P、PDQC、SCICP对患者精神障碍情况进行评估。分析影响患者精神障碍的相关因素。结果单因素分析结果显示,年龄、文化程度、职业满意度、家庭满意度、颅脑损伤性质、颅脑损伤程度、单纯额损伤、单纯颞叶损伤、额颞叶损伤等是影响患者发生精神障碍的因素(P〈0.05或P〈0.01)。多因素回归分析结果显示患者年龄、颅脑损伤程度、单纯额损伤、单纯颞叶损伤、额颞叶损伤是影响患者精神障碍的因素(P〈0.01)。结论年龄、颅脑损伤程度、单纯额损伤、单纯颞叶损伤、额颞叶损伤是影响患者精神障碍的因素。
Objective To analyze related factors of mental disorder after craniocerebral injury. Methods Selected 336 cases with craniocerebral injury were surveyed by general information questionnaire, intelligence test, memory quotient test and SCID-1/P、PDQC、SCICP to assess mental disorder. Results Results of the single factor analysis showed age, culture level, occupation, family satisfaction, craniocerebral injury, the degree of craniocerebral injury, purely frontal lobe damage, pure temporal lobe damage, the frontal and temporal lobe damage were the influence factors of mental disorders(P < 0.05 or P < 0.01). Multiple factors analysis results showed age, the degree of craniocerebral injury, purely frontal lobe injury, pure temporal lobe damage, the frontal and temporal lobe damage were the influencing factors of patients with mental disorders(P < 0.01). Conclusion Age, the degree of craniocerebral injury, purely frontal lobe injury, pure temporal lobe damage, the frontal and tempo

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“岛癫痫”是一个早就提出的概念,当时人们发现刺激岛能产生类似于颞叶癫痫的症状,两者临床症状相似,非常容易混淆.但由于岛解剖的特殊性,手术操作十分困难,制约了对岛癫痫的研究.近年来随着各种新技术的应用,越来越多的研究证实:岛受累是颞叶癫痫手术治疗失败的一个重要原因[1].因此,岛在难治性癫痫,尤其在颞叶癫痫中的作用日益受到重视.本文重点论述结构影像学检查未发现明确病灶的岛癫痫.
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颞叶变性(frontotemporal lobar degeneration,FTLD)通常为一病理解剖术语,描述选择性的额颞叶前部的萎缩。临床表现为行为、人格改变和失语,包括3种临床综合征:
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目的 利用默念产词任务研究颞叶癫痫患者与健康对照语言网络的差异性,从而揭示颞叶癫痫患者涉及语言功能区域的核心节点.方法 共纳入32例颞叶癫痫患者和32名性别和年龄相匹配的健康对照.所有受试者在默念产词任务下扫描功能磁共振数据.利用MATLAB平台SPM8软件对数据进行处理.采用条件Granger因果检验方法研究颞叶癫痫患者语言网络节点之间的因果关系.结果 与健康对照相比,颞叶癫痫患者产词任务时激活增强区域包括右侧后扣带回和右侧楔前回,未发现激活降低的区域.条件Granger因果检验分析发现,患者组在左侧楔前回到左侧岛,左侧岛到左侧后扣带回以及左侧额中回到右侧岛的单向条件Granger因果连接增加.结论 岛、后扣带回均参与了颞叶癫痫患者语言网络,可能为语言网络重组以及大脑可塑性提供了影像学证据.
Objective Temporal lobe epilepsy (TLE) patients often have language impairment.The present study is to examine the effective connectivity within the language network in TLE patients by analyzing functional magnetic resonance imaging (fMRI) while performing a silent verb generation task.Methods Thirty-two TLE patients and thirty-two healthy controls were recruited in the study.The fMRI was recorded while the subjects performing verb-generation task.The brain imaging data were analyzed using MATLAB-SPM8 mapping program.The correlation of the connectivities within the language network was analyzed by means of Granger causality.Results Compared to the controls,the activated areas in TLE patients are mainly located in right posterior cingulate gyrus and right precuneus.Granger causality mapping implied a possible correlation between left precuneus and left insular,left insular and left posterior cingulate gyrus,and between left medial frontal gyrus and right insular.Conclusion Granger causa
目的 探讨18F-FDG PET/MRI异机融合对影像学阴性的难治性颞叶癫痫术前病灶定位、预测预后、指导手术的价值.方法 45例难治性颞叶癫痫患者,行头颅MRI,视频脑电图,及脑PET-CT等术前检查,头颅MRI结果均为阴性,术后2年随访手术疗效,采用Engel''s分级评价疗效,后将同一患者的头颅MRI与PET进行异机融合,与手术疗效相结合分析PET/MRI脑代谢图形与手术疗效的关系.结果 37例PET/MRI提示低代谢局限于颞叶的患者中,术后疗效为Ⅰ、Ⅱ级的有29例,22例(76%)患者低代谢位于颞叶内侧;Engel''sⅢ,Ⅳ级患者有8例,6(77%)例患者低代谢超出前颞叶.使用卡方检验低代谢分区与手术疗效的关系,P <0.05,差异有统计学意义.结论 PET/MRI提示局限于颞叶内侧、极和前颞叶的代谢减低,术后疗效好.PET/MRI融合是一种更加精确的成像,PET/MRI的代谢图型可帮助临床医生确定病灶部位、预测疗效.
Objective Compared to 18F-FDG PET-CT,to validate the use of interictal 18FFDG PET/MRI registration in the location of epilepsitic lesions and prediction of surgical outcome.Methods Forty-five patients of intractable temporal lobe epilepsy were recruited retrospectively.All patients underwent persurgical evaluation included clinical symptoms,long-term video electroencephalogram(VEEG),PET-CT,and MRI.They were followed-up at least 2 years after surgery and evaluated with Engel''s classification.Both volumes of PET and 3D MRI were coregistered into PET/MRI using Siemens 3D volume software to study the relationship between the metabolic patterns of PET/MRI and surgical curative effects.Results The postoperative effect demonstrated that among 37 patients with limited temporal low metabolism detected by PET/MRI,29 cases reached to grade Ⅰ or Ⅱ effects and 22 cases (76%) showed the low metabolism restricted to mesial temporal lobe,while 8 cases reached Engel''s grade Ⅲ or Ⅳ and

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目的探讨伽玛刀与手术治疗颞叶癫痫的疗效,寻求更佳的颞叶癫痫治疗方法。方法回顾性分析我院接受伽玛刀治疗颞叶癫痫患者35例,治疗边缘剂量15~25 Gy,接受手术治疗颞叶癫痫患者102例,随访患者治疗后癫痫控制情况。结果随访时间3~7年,平均4.5年,伽玛刀治疗组EngelⅠ级7例,EngelⅡ级8例,EngelⅢ级9例,EngelⅣ级11例,手术治疗组:EngelⅠ级69例,EngelⅡ级15例,EngelⅢ级10例,EngelⅣ级8例,两者差异有显著统计学意义(P0.0001)。结论手术治疗颞叶癫痫疗效显著优于伽玛刀治疗,伽玛刀术后癫痫缓解率低,并发症多,目前尚不能作为颞叶癫痫的常规治疗。
Objective To explore the efficacy of gamma knife and surgery treatment for temporal lobe epilepsy in order to seek for better treatment of temporal lobe epilepsy .Methods The clinical data of 35 patients with temporal lobe epilepsy treated by gamma knife in our department were analyzed retrospectively .The marginal dose ranged from 15-25 Gy.In the same period , 102 patients with temporal lobe epilepsy were underwent operation , and accepted the follow up after operation . Results The follow-up period ranged from 3 to 7(mean 4.5) years,Engel''s criteria were used to classify seizure outcome ,in the gamma knife treatment group ,seizure control of EngelⅠin 7 cases,EngelⅡin 8,EngelⅢin 9 and EngelⅣin11.While the surgical treatment groups showed EngelⅠin 69 cases, EngelⅡin15,EngelⅢin 10 and Engel Ⅳin 8.There was statistically significant difference between gamma knife and surgery treatment group for temporal lobe epilepsy (P <0.0001).Conclusion Surgery treatment for tempora

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目的:探讨内侧颞叶癫痫患者中海马硬化的比例及影像学特点。方法选择2012年2月到2013年12月期间本院收治的78例内侧颞叶癫痫患者,采取磁共振成像(magnetic resonance imaging,MRI)测量海马体积,结合目测法进行海马硬化的判定,采取磁共振波谱(magnetic resonance spectroscopy, MRS)分析NAA (N-乙酰天门冬氨酸)浓度与(Cr±Cho)(肌酸±胆碱)的比值,与健康对照人群和非内侧颞叶癫痫患者进行比较。结果内侧颞叶癫痫组海马硬化的比例为58.97%,显著高于健康对照组和非颞叶内侧起源的癫痫组。内侧颞叶癫痫组的平均海马体积(2305.68±814.61 mm3、2456.71±743.60 mm3)同样较两组明显缩小。MRI上74.55%的内侧颞叶癫痫海马硬化表现为海马萎缩和T2WI信号增高。其海马硬化以左侧为多见(52.17%),有时可出现双侧海马硬化(19.57%)。MRS测定表明硬化的海马NAA/(Cr±Cho)显著降低(0.58±0.19)。结论海马硬化可能是内侧颞叶癫痫的主要影像学特点,其中海马萎缩和T2WI信号增高具有普遍性和特征性。
Objective To explore the incidence and imageological features of patients with the hippocampal sclerosis-associated medial temporal lobe epilepsy. Methods Seventy-eight patients with the medial temporal lobe epi?lepsy were recruited from our hospital during February 2012 to December 2013. Magnetic resonance imaging (MRI) and resonance spectroscopy (MRS) analysis were conducted in patients with with the hippocampal sclerosis-associated medial temporal lobe epilepsy, patients with epilepsy without the medial temporal lobe diseases and healthy controls. Results The incidence of hippocampal sclerosis was 58.97%among patients with medial temporal lobe epilepsy which were significantly higher compared with either healthy control group or patients with epilepsy without the medial tempo?ral lobe diseases. The average hippocampal volume of the medial temporal lobe epilepsy group(2305.68±814.61 mm3、2456.71±743. 60 mm3)was significantly smaller compared with either healthy controls o

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目的:探究额颞叶痴呆患者的临床症状以及早期诊断方法。方法:选自本院2002年-2013年收治的额颞叶痴呆患者20例,对其临床资料以回顾性方法进行分析,归纳此类患者的临床特征。结果:额颞叶痴呆患者早期症状由高到低排列主要如下:人格改变、记忆力下降、语言障碍、精神行为症状。随着病情的逐渐加深,患者会出现各种非典型性的症状,诸如失眠、注意力不集中、冷漠、情绪不稳定以及收藏癖等。对额颞叶痴呆患者的早期诊断,符合率大约为50%。结论:额颞叶痴呆患者临床表现多种多样且没有典型表现,对此类患者的早期诊断需综合考虑各种因素,警惕患者的首发症状。
Objective: to explore the clinical symptoms of patients with frontotemporal dementia (FTD) as wel as the method of early diagnosis. Methods: selected from our hospital in 2002-2002, 20 cases of FTD patients, to analyze its clinical data with retrospective method, summarized clinical features in patients with. Results: the FTD patients early symptoms from high to low arrangement is mainly as fol ows: personality changes, memory drops, the language barrier, mental behavior symptom. , as the condition of patients may appear al sorts of atypical symptoms, such as insomnia, inattention, apathy, emotional instability and a pack rat, etc. In patients with frontotemporal dementia (FTD) in early diagnosis of coincidence rate is about 50%. Conclusion: clinical manifestations of patients with frontotemporal dementia (FTD) a variety that is typical and no early diagnosis in such patients should be comprehensive consideration of various factors, alert starting symptoms of patients.

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