脑电联合同步功能MRI在局灶性癫痫检测中的应用价值

Detection of focal epileptic activity using combined simultaneous electroencephalogram-functional MRI

目的探讨脑电监测模式的脑电同步功能 MR 成像(EEG-fMRI)技术在局灶性癫痫患者间期痫样放电引起的脑区激活情况的应用价值。方法对12例局灶性癫痫患者进行 EEG-fMRI数据采集;以间期痫样放电的事件相关设计模式对 fMRI 数据进行分析,观察癫痫放电引起脑激活的时空分布情况。并与 MR 结构成像病灶定位结果进行对比。结果 12例患者中,共采集到10例患者的18次有效 EEG-fMRI 数据。与结构病灶相对比,11次数据显示定位结果较好,5次结果尚可,2次结果不佳;其中6例患者2次采集的定位结果相同。18次扫描结果均显示激活大脑对侧的小脑有稳定的激活;10次结果中丘脑有正激活信号,9次有位于典型的缺省状态分布脑区的负激活信号。结论EEG-fMRI 技术利用多模态神经成像技术的优点,在癫痫的研究方面有较大的应用价值。

Objective To observe the brain activation of interictal epiletiform discharges （IEDs） and to localize the epileptogenic foci of epilepsy. Methods The electroencephalogram （EEG） and functional MRI data of 12 focal epileptic patients were acquired using a combination of EEG and functional MRI simultaneously. The IEDs onset time detected with EEG were set as the time parameters in an eventrelated paradigm of functional MRI analysis. The spatial and temporal characters of IEDs activation were analyzed in detail. In order to confirm the consistency of this method, all patients were scanned repeatedly and the results were correlated with clinical evaluation. Results Of the 12 patients, valid data from EEG- fMRI were obtained from 10 patients in a total of 18 sessions.. Compared with the structural foci, the epileptic foci localization results of eleven sessions were good, five sessions were fairly good, and two sessions were poor. The results obtained from six patients in two separate sessions were concordant, respectively. Moreover, thalamic activation was detected in ten sessions, cerebellar activation was detected in all sessions, and the deactivation was found in the default mode loci in nine sessions. Conclusion The method of performing EEG and fMRI simultaneously can potentially be a useful tool in epilepsy research.