小儿癫痫的SPECT、EEG和MRI的对比研究

Study on localization diagnosis with SPECT rCBF imaging in childhood epilepsy: in comparison with EEG and MRI findings

目的评价ＳＰＥＣＴ脑血流灌注显像在小儿癫痫灶定位诊断的价值。方法对７４例发作间期、１０例发作期，共８４例癫痫患儿行ＳＰＥＣＴ脑血流灌注显像及ＥＥＧ检查，其中６７例作了ＭＲＩ检查，并对各种检查结果进行比较。结果ＳＰＥＣＴ、ＥＥＧ和ＭＲＩ的异常率分别为８２１４％、７１４３％和４７７６％；ＥＥＧ异常的６０例患儿中与ＳＰＥＣＴ异常部位完全或基本符合率为７０５９％；ＭＲＩ异常的３２例患儿中１７例有局部病灶，其中与ＳＰＥＣＴ符合率为５８８２％。结论ＳＰＥＣＴ脑血流灌注显像是诊断小儿癫痫病灶的有效方法，灵敏度优于ＥＥＧ和ＭＲＩ；但ＳＰＥＣＴ所示异常范围并非都是致痫灶，应与ＥＥＧ和ＭＲＩ结合分析，提高其定位准确性。

Objective To evaluate the diagnostic value of SPECT rCBF imaging in localization of childhood epileptic foci Methods rCBF imaging was performed in 74 epileptic patients not in seizure and 10 epileptic patients right in seizure EEG was performed in 84, MRI in 67 of the subjects mentioned above All the results of three modalities were compared with each other Results The highest positive rate (82 14%) was found in SPECT rCBF imaging, the positive rate in EEG or MRI was 71 43% or 47 76% The epileptic foci localized by EEG (60 abnormalities) and by MRI (32 abnormalities) were 70 59% and 58 82% in concordance with those by SPECT, respectively Conclusions SPECT rCBF imaging is a sensitive and effective method for epileptic foci localization It may have some advantages over EEG and MRI in detecting and localizing epileptic foci However, abnormal SPECT areas may cover some abnormalities which do not belong to epileptic category A combination of these three methods (SPECT, EEG and MRI) will improve the positive rate and accuracy for localizing