^18F—FDGPET／CT脑显像与EEG用于颞叶癫痫灶术前定位

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

目的对比研究^18F—FDGPET／cT脑显像与EEG对颞叶癫痫灶术前定位的价值。方法回顾性分析临床诊断为颞叶癫痫的患者152例，其中男108例，女44例，年龄范围3—59岁。所有患者行^18F—FDG PET／CT脑显像和长程和（或）视频EEG检查，其中29例无法准确定位者行颅内电极EEG检查。所有患者行手术治疗，手术切除组织行病理检查，以术后病理为“金标准”，术后随访6个月以上。用，检验对PET／CT脑显像及长程和（或）视频EEG的准确性进行统计学分析。结果152例患者PET／CT脑显像定位致痢灶的准确性为80．92％（123／152），长程和（或）视频EEG定位致痈灶准确性为43．42％（66／152），2种检查方法定位致痫灶的准确性差异有统计学意义（Х^2=22．72，P〈0．01），29例术前无法准确定位的患者行颅内电极EEG定位致痫灶，其准确性为100％。结论发作间期^18F—FDGPET／CT脑显像定位癫痫灶价值优于长程和（或）视频EEG，与颅内电极EEG联合使用，可进一步提高对致痫灶定位的准确性。

Objective To compare the value of ^18SF-FDG PET/CT brain imaging and EEG in preoperative localization of the epileptic focus at the temporal lobe. Methods A total of 152 patients （108 males, 44 females, age ranged from 3 to 59 years old） with past history of temporal lobe epilepsy were included. All patients underwent JSF-FDG PET/CT brain imaging and long-range or video EEG, and 29 patients underwent intracranial electrode EEG due to the failure to localize the disease focus by non-invasive methods. Histopathologic findings after operative treatment were considered the gold standard for disease localization. All patients were followed up for at least six months after the operation. The accuracy of the ISF- FDG PET/CT brain imaging and long-range or video EEG examination were compared using Х^2 test. Results The accuracy of locating the epileptic focus was 80.92% （123/152） for ISF-FDG PET/CT brain imaging and 43.42% （66/152） for long-range or video EEG （Х^2 = 22.72, P 〈 0.01 ）. The accuracy of locating the epileptic focus for the 29 cases with intracranial electrode EEG was 100%. Conclusions Interictal ISF- FDG PET/CT brain imaging is a sensitive and effective method to locate the temporal lobe epileptic focus and is better than long-range or video EEG. The combination of ^18F-FDG PET/CT brain imaging and intracranial electrode EEG examination can further improve the accuracy of locating the epileptic focus.