脑ECT血流灌注显像对全身发作型癫痫诊断价值的研究

STUDY ON THE DIAGNOSTIC VALUE OF BRAINSPEOT BLOODPERFUSION IMAGING FOR SYSTEMIC EPILEPSY

目的：评估９９ｍＴｃ－乙撑双半胱氨酸二乙酯（ＥＣＤ）－ＳＰＥＣＴ脑血流灌注显像对全身发作型癫痫（包括癫痫大发作和失神小发作）病灶定位诊断的临床价值，并分析其影像学特点，还与ＣＴ、ＭＲＩ和ＥＥＧ（脑电图）的诊断结果进行对比分析。方法：分别进行ＥＣＴ、ＭＲＩ、ＣＴ显像和ＥＥＧ检查。结果：ＥＣＴ脑血流灌注显像对本型癫痫病灶的阳性检出率为８４．２％（６４／７６），显著高于ＭＲＩ、ＣＴ和ＥＥＧ。而ＥＥＧ的阳性检出率也达５２．６％（４０／７６），但它的定位诊断价值较小。从ＥＣＴ检出的病灶在脑叶分布特点看：颞叶最多，其次分别为额叶、枕叶和顶叶。结论：ＥＣＴ显像的探测灵敏度显著高于ＭＲＩ、ＣＴ和ＥＥＧ，定位诊断价值也优于ＥＥＧ检查。全身发作型癫痫的脑ＥＣＴ血流灌注影像表现为多个脑叶同时受累或一侧颞叶受累。

Objective:The clinical value of 99m Tc-SPECT brain blood perfution imaging was evaluated in allocative diagnosis to the focus of general seizure of epilepsy (including grandminal epilepsy and minor epilepsy), and it’s imaging charcter was analysed and it was compared with the outcome of X-ray CT, MRI and EEG. Methods:In 78 patients 99m Tc-ECT SPECT, X-ray CT, MRI and EEG were performed. Results: The positive rate of the epileptic focus of brain SPECT blood fuetion imaging is 84.2%, much higher than MRI,CT,and EEG. The EEG positive rate reaches 52.6 percent, but it has monor diagnosis value of allocation. From the character of epileptic focus distribution in brain SPECT Imaging. We can see: most focuses are in temporal lobe, less in frontal lobe, parietal lobe, and occipital lobe respectively. Conclusion:The detection sentivity of SPECT is distinctively higher than MRI, CT and EEG. The SPECT imaging of general seizure epilepsy shows that more than one brain lobes are abnormal simultaneusly, or just one side of temporal lobe is abnormal. The proportional rate of abnormal area is significantly higher than the other lobes.