PET/CT与脑电图和MRI对难治性癫痫的对比研究

Comparative study on diagnosis of refractory epilepsy by PET/CT,EEG and MRI

目的探讨正电子发射断层扫描/计算机断层成像(PET/CT)、脑电图(EEG)和磁共振成像(MRI)在难治性癫痫病灶定位方面的诊断价值。方法 2005年12月至2009年12月就诊于内蒙古医学院附属医院的50例难治性癫痫患者,男32例,女18例,平均年龄(20±18)岁,病程平均(7±11)年,均行EEG和MRI检查及18F-FDG PET/CT(发作期PET/CT显像8例,发作间期显像42例),并对全部病例癫痫病灶的检出率及一致性进行比较。结果 PET/CT显像异常率92%(46例),其中低代谢灶39例,高代谢灶5例,低代谢灶和高代谢灶共存2例。EEG异常率74%(37例),MRI异常率36%(18例)。在病灶定位诊断上PET/CT与EEG一致率为72%,PET/CT与MRI的一致率为36%,MRI与EEG的一致率为32%。结论 PET/CT显像对难治性癫痫病灶的探测敏感性高于EEG和MRI,在病灶诊断上PET/CT与EEG一致性高于MRI与EEG。

Objective To study the diagnostic value of PET/CT,EEG and MRI for foci localization with refractory epilepsy.Methods Fifty patients from December 2005 to December 2009 in our hospital with refractory epilepsy patients（male 32 cases,female 18 cases,age from 4 to 46,duration of disease from 5 to 25 years.All patients understood PET/CT,EEG and MRI and rate of epileptic diagnostic localization and consistency in PET/CT,EEG and MRI were analyzed and compared.Results PET/CT positive rate was 92%,with low metabolic foci in 38 cases,high metabolic foci in 5 cases,and both in 2 case.EEG positive rate was 74%（37 cases）,MRI positive rate was 36%（18 cases） .Consistency of foci diagnostic localization between PET/CT and EEG was 72% .Consistency of foci diagnostic localization between PET/CT and MRI was 36% .Consistency of foci diagnostic localization between MRI and EEG was 32% .Conclusions PET/CT imaging is more sensitive than EEG and MRI in detecting epileptic foci of children in refractory cases.Consistency between PET/CT and EEG is well over that between MRI and EEG in foci localization