^(18)F-FDG PET-CT脑显像与EEG对颞叶癫痫灶术前定位价值的对比研究

Comparative studies of the value of ^(18)F-FDG PET-CT brain imaging and EEG in preoperative localization of temporal lobe epileptic focus

目的对比18F-FDG PET-CT脑显像与EEG对颞叶癫痫灶术前定位的价值。方法回顾性分析经我院神经外科癫痫中心临床诊断为颞叶癫痫的患者152例,所有患者术前行18F-FDG PET-CT脑显像、长程/视频EEG检查,其中29例定位仍不确切者行颅内电极EEG检查,手术切除组织术后送病理检查,比较结果。结果 (1)本组152例患者PET-CT脑显像定位致痫灶的准确率为80.92%(123/152),长程或视频EEG定位致痫灶准确率为43.42%(66/152),两种检查方法定位致痫灶准确率差异有统计学意义(χ2=45.44,P<0.01);(2)本组29例患者颅内电极EEG定位致痫灶准确率为100%。结论发作间期18F-FDG PET-CT脑显像定位致痫灶灵敏、有效,其价值优于长程/视频EEG;18F-FDG PET-CT脑显像对颅内电极埋置有指导价值,两者联合使用,可以进一步提高致痫灶定位准确率。

Objective To contrast the value of 18F-FDG PET-CT brain imaging and EEG in preoperative localization of temporal lobe epileptic focus.Methods 152 patients who were diagnosed temporal lobe epilepsy in Neurosurgery Epilepsy Center of our hospital all underwent 18F-FDG PET-CT brain imaging and long range or video EEG examination,in which 29 cases still failed to locate epileptic focus underwent intracranial electrodes EEG examination.Then compared above results with pathology of removal tissue after surgery.Results（1）The rate of accurately locating epileptic focus is 80.92%（123/152） for PET-CT brain imaging and 43.42%（66/152） for long-range or video EEG,there was significant difference of accurate localization rate between the two methods（χ2 = 45.44,P0.01）;（2）The accurate localization rate for intracranial electrodes EEG of 29 cases was 100% in this group.Conclusion Interictal 18F-FDG PET-CT brain imaging is a sensitive and effective method to locate temporal lobe epileptic focus and is better than long-range or video EEG;18F-FDG PET-CT brain imaging is valuable for directing intracranial electrode placement,the two combination can further improve accurate localization rate of epileptogenic focus.