Mối liên quan giữa đặc điểm hình ảnh xơ hóa hồi hải mã và tình trạng động kinh sau phẫu thuật

Abstract

Objective: To evaluate the association between hippocampal sclerosis (HS) on magnetic resonance imaging (MRI), hippocampal subfield volumes, and surgical outcomes in patients with mesial temporal lobe epilepsy (mTLE-HS). Subject and method: A retrospective study was conducted on 30 patients who underwent selective amygdalohippocampectomy at Viet Duc University Hospital. Three-dimensional 3.0 Tesla MRI images were processed using HippUnfold for hippocampus segmentation and volumetric extraction of the subiculum, CA1, CA2, CA3, CA4, DG, SRLM, and the whole hippocampus. The volume ratios of the affected side to the contralateral side was compared among Engel outcome groups. Result: The postoperative Engel I seizure-free rate was 63.3% (19/30). In the typical HS group (type 1) the Engel I rate was 68.0%, compared with 40.0% in the atypical HS group (type 2/3). The Engel I group showed more pronounced ipsilateral atrophy than the Engel II-IV group in the whole hippocampus, CA1, CA4, and DG (p<0.05), while no significant differences were observed in the subiculum, CA2, CA3, and SRLM subfields (p>0.05). Conclusion: The typical HS group tended to have better postoperative seizure control, although the difference did not reach statistical significance. Greater atrophy of the whole hippocampus and the CA1, CA4, and DG subfields was associated with Engel I outcomes.