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PET结合视频脑电图对MRI阴性难治性癫痫致痫灶的术前定位 被引量:7

Positron emission tomography plus VEEG in the localization of epileptic foci in negative-MRI interact epilepsy
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摘要 目的评价正电子发射计算机断层(PET)在MRI阴性致痫灶定位诊断中的意义。方法对61例癫痫患者行头MRI、视频脑电图(VEEG)和发作间期”F-FDG联合13N-NH,·H2O—PET检查,将MRI阴性手术患者术前定位与术后疗效比较,并对MRI阳性与MRI阴性两组问PET、VEEG结果进行比较。结果Mill阴性组26例,阳性组35例;VEEG定位致痫灶提示:脑区性12例,多脑区性16例,半球性13例,不能定位20例;PET显像61例均有异常改变:脑区性23例,多脑区性28例,半球性5例,不能定位6例。17例MRI阴性患者术后Engels标准达Ⅰ-Ⅱ级的12例占70.59%,对两组间PET、VEEG定位分别进行比较,差异均无统计学意义;分别对两组的PET与VEEG比较,差异均有统计学意义。结论PET是一种对致痫灶定位敏感性、准确性较高的功能影像检查技术,特别在MRI阴性时,PET是定位致痫灶必不可少的检查手段。 Objective To explore the application value of positron emission tomography (PET) in the localization of magnetic resonance imaging (MRI) -negative epileptogenic focus. Methods Brain images of is fluoro-2-deoxy-D-glucose ( is F-FDG) and 13 N_NH3 . H2 O-PET, MRI and video electroencephalography (VEEG) were obtained in 65 patients. Preoperative and postoperative localizations were compared in MRI- negative patients. And the results of PET and VEEG were compared between the MRI-positive and MRI- negative groups. Results MRI scans were normal in 26 cases and abnormal in 35 cases. Sixty-one patients had interictal epileptiform discharge on VEEG (brain regions, n = 12; multiple brain areas, n = 16; hemisphere, n- 13; unspecified location, n = 20) and interictal PET imaging (brain regions, rt = 23; multiple brain areas, n = 28 ; hemisphere, n = 5 ; unspecified location, = 6 ). And 17 MRI-negative patients underwent operations and 12 of them reached the Engels Ⅰ - Ⅱ level standard. Both PET and VEEG were compared between the MRI-positive and MRI-negative groups. No significant differences existed between two group ( P 〈 0. 05 ). A comparison of PET and VEEG showed statistical significance in two group (P 〉 0.05 ). Conclusion PET imaging is both sensitive and effective in the detection and localization of epileptogenic loci. Especially for MRI-negative eases, it is an indispensable tool of localizing epileptogenie foci.
出处 《中华医学杂志》 CAS CSCD 北大核心 2012年第9期600-603,共4页 National Medical Journal of China
基金 天津市科委科学基金(06VFJMJC07900)
关键词 癫痫 定位 正电子发射断层显像 脑电描记术 核磁共振成像 Epilepsy Location Positron emission tomography(PET) EEG MRI
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参考文献6

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