摘要目的采用功能性MRI(functional MRI)对颞叶癫痫患者颞叶语言优势半球进行定位,为手术方式的选择提供依据.方法 12例颞叶癫痫患者接受颞叶语言皮层的功能性MRI扫描,其中4例接受阿米妥试验;癫痫灶位于功能性MRI提示为优势半球的病例接受选择性海马杏仁核切除术,癫痫灶位于非优势半球的病例接受前颞叶切除术.结果 10例为左侧语言优势;2例右侧语言优势;4例接受阿米妥实验的病例的优势半球与功能性MRI结果一致;7例接受前颞叶切除,5例接受选择性海马杏仁核切除;术后患者未出现语言功能障碍.结论采用功能性MRI可对颞叶优势半球作出正确定位,指导对颞叶癫痫手术方式的选择.

abstractsAbstract:Objective To determine the dominant language hemisphere in patients with intractable temporal lobe epilepsy before surgical treatment by using functional MRI (fMRI). Methods Twelve patients underwent fMRI. Among them, 4 patients also underwent the Wada test. Anterior temporal lobectomy was performed on patients with epileptic focus on the non-dominant hemisphere, and selective amygdalo-hippocampectomy on patients with epileptic focus on the dominant hemisphere.Results Ten patients had left dominance, and 2 right dominance. The fMRI results were concordant with Wada test results in the 4 patients who accepted the Wada test. Seven patients underwent anterior temporal lobectomy, and 5 underwent selective amygdalo-hippocampectomy. There was no post-operative dysphasia. Conclusion fMRI is an alternative method of noninvasive functional mapping for language dominance in patients with temporal lobe epilepsy.