脑磁图对有颅内肿瘤的癫痫病人局部致痫灶的定位价值

Evaluation of the role of magnetoencephalography for predicting focal epileptogenicity in the patients with brain tumors

目的研究脑磁图(magnetoencephlography,MEG)在颅内肿瘤的癫痫病人中致痫灶的定位价值.方法选择经手术、病理证实的颅内肿瘤25例,术前通过148信道MEG系统记录和分析自发脑磁活动.结果本组25例患者中有21例术前致癫灶MEG定位结果与术中ECoG证明的一致,两者符合率达84%.术后随访3～37个月,平均17个月.手术总有效率达96%.25例患者中19例肿瘤的位置和癫痫灶的位置一致,致癫灶位于肿瘤边缘者10例;距肿瘤约2cm者9例;远隔部位异常者4例;MEG检查没有阳性发现者2例.结论MEG对于预测颅内肿瘤的致痫灶是一种有用的方法,它有助于制定切除病变并同时处理癫痫外科的手术计划.

Objective To evaluate the value of magnetoencephalography（MEG） in identifying the irritatic epileptic zone in epileptic patients with brain tumors. Methods Presurgical spontaneous brain magnetic activities were recorded by means of a 148 channels dual unit MEG system（Magnes 2500WH,4- D Neuroimaging） in 25 epilepsy patients with intracranial tumors. In all of the patient the tumor were taken off and got a pathological examination. Results In 21/25 （84 % ） patients the results of preoperative MEG were coincident with interoperative ECoG operatively. Following up 3--37 （average17） months, the efficient rate of surgery was 96%. The epileptogenic zone was found in the margin of the tumor in 10 patients and in the area 2 cm far from the margin of the tumor in 9 patients. There was no spike found in 2 patients. Conclusion MEG is a promising method for prediction of the epileptogenic zone in epileptic patients with brain tumors.