目的：探讨氢质子磁共振波谱分析对儿童癫痫诊断中的应用价值。方法将34例经24 h动态脑电图确诊的癫痫患儿设为患者组，20例无神经系统症状和体征、无脑实质病变的非癫痫患儿设为对照组，采用3．0T M R扫描仪，先行常规T1WI、T2WI扫描，氢质子磁共振波谱检查采用多体素解析波谱采集序列，分析双侧海马区代谢产物乙酰‐天门冬氨酸、复合胆碱、肌酸的波峰特点，计算乙酰‐天门冬氨酸／（复合胆碱＋肌酸）和乙酰‐天门冬氨酸／肌酸的比值，并与动态脑电图进行比较。结果两组常规磁共振检查均未见脑结构及信号异常。患者组病灶侧乙酰‐天门冬氨酸峰可见不同程度降低，复合胆碱、肌酸峰可见不同程度增高；患者组病灶侧乙酰‐天门冬氨酸／（复合胆碱＋肌酸）和乙酰‐天门冬氨酸／肌酸的比值较病灶对侧、对照组明显减小（P＜0．01），病灶对侧与对照组比较差异无显著性（P＞0．05）。氢质子磁共振波谱诊断准确率为85．2％、敏感度为94．1％。结论氢质子磁共振波谱能够定量反映患儿海马代谢异常，有助于癫痫的早期诊断。%Objective To explore the application value of 1 H magnetic resonance spectroscopy (1 HMRS) in the diagnosis of children with epilepsy .Methods Routine T1WI and T2WI scans were performed in ad‐vance using 3 .0T magnetic resonance scanner(MRI)in thirty‐four children with epilepsy diagnosed by 24 h ambulatory EEG (AEEG ,patient group) and 20 non‐epilepsy child patients without neurologic symptoms , signs and brain parenchyma lesion (control group ) and 1 H magnetic resonance spectroscopy using multi voxel point analysis spectrum sequences ,peak characteristics of N‐acetylas‐partate(NAA) ,choline‐contai‐ning compounds(Cho)and creatine(Cr)in bilateral hippocampal regions analyzed ,and the ratio of NAA/(Cho + Cr) and NAA/Cr calculated and compared with AEEG .Results Routine MRI scans of both groups had no abnormal brain structure and signal .In focus side NAA peak lowered in different degrees and Cho and Cr heightened in patient group ;the ratio of NAA/(Cho+Cr) and NAA/Cr in focus side in patient group reduced more significantly compared with those in opposite side and in control group (P<0 .01) ,there were no significant differences in those between in opposite side and in control group (P>0 .05) .Accuracy rate and sensitivity of 1 HMRS was respectively 85 .2% and 94 .1% .Conclusion 1H‐M RS could quantitatively reflect hippocampal metabolic disturbance of child patients and is conduce to the early diagnosis of epilepsy .
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