目的 采用动态磁敏感对比增强 (dynamic susceptibility contrastenhanced，DSC)灌注成像探讨颞叶癫痫 (temporal lobe epilepsy，TLE)患者发 作间期内侧颞叶灌注改变。方法 对经过 手术病理证实的15例发作间期右利手TLE 患者及相匹配15例正常对照者行DSC检 查。在工作站上重建出DSC的相对脑血容 量(relative cerebral blood volume， r C B V )图及相对脑血流量 ( r e l a t i v e cerebral blood flow，rCBF)图，结合 高分辨率解剖像，选取两侧内侧颞叶作为 感兴趣区(region of interest，ROI)， 计算病例组及正常对照组两侧内侧颞叶的 rCBV值 、rCBF值，比较病例组及正常对 照组两侧内侧颞叶rCBV 、rCBF的不对称 指数(asymmetry index，AI)的差异。结 果 1、正常对照组双侧内侧颞叶rCBV值、 rCBF值差异无统计学意义(P>0.05)。2、 TLE组患侧rCBV值、rCBF值均低于对侧， 差异有统计学意义(P<0.05)。3、TLE组 AIrCBV、AIrCBF均高于正常对照组，差异 有统计学意义(P<0.05)。4、TLE患者内侧 颞叶AIrCBF值、AIrCBV值均与病程呈正相 关。结论 TLE发作间期患侧内侧颞叶rCBV 值、rCBF值降低，TLE患者的血流灌注改 变与患者病程具有一定的相关性，表现为 随着TLE患者病程的延长，其灌注不对称 性越高。

Objective To investigate the medial temporal lobe perfusion changes in patients with temporal lobe epilepsy (TLE) in interictal period using dynamic susceptibility contrast enhanced (DSC) perfusion imaging. Methods 15 patients with pathologically confirmed right-handed TLE and matched 15 cases normal control were underwent DSC examination. Reconstructed the relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) using the workstation software, selected on both sides of the medial temporal lobe as region of interest combinedwith high-resolution anatomical image, then calculated the rCBV values, rCBF values and asymmetry index (AI), and compared the value between the the TLE group and the control group. Results 1. The rCBV and rCBF values in medial temporal lobe in normal control group showed no significant difference (P>0.05). 2. The rCBV and rCBF values in medial temporal lobe in affected side were lower than opposite side in TLE group, the difference was statistically significant (P<0.05). 3. The AIrCBV, AIrCBF in TLE group were higher than the normal control group, the difference was statistically significant (P<0.05). 4. AIrCBF and AIrCBV values in medial temporal lobe of TLE patients were positively correlated with disease course. Conclusion The rCBV and rCBF values were decreased in medial temporal lobe in patients with TLE in interictal period，the blood perfusion changes correlated with disease course in TLE patients，The longer the duration, the higher the perfusion asymmetry.