MRI、PET-CT联合定位应用γ刀治疗脑灰质异位症癫痫患者的临床研究

CLINICAL STUDY ON THE TREATMENT OFHETEROTOPIC GRAY MATTER EPILEPSY WITH γ-KNIFETHRO UGHL OCALIZATION COMBINED MRI WITH PET-CT

目的:探讨MRI,PET-CT,联合定位后应用γ刀治疗脑灰质异位症癫痫患者的临床疗效。方法:对经MRI证实的脑灰质异位症所致的6例难治性癫痫患者,根据严格的临床检查,发作时的临床表现,电生理等检查,联合PET-CT扫描,针对MRI检查中呈团块或孤立的病灶,应用γ刀进行规划,治疗,术后定期复查,随访4～24个月,采用国际癫痫学会外科手术疗效分类法进行评估。结果:6例患者经伽马刀治疗后Ⅰ级1例;Ⅱ级3例;Ⅲ级1例;Ⅳ级1例,有效率为83%,未出现并发症。结论:通过MRI,PET-CT联合定位,综合应用各项检查,可以大大提高致痫灶的准确性,优化治疗方案,指导临床治疗,提高治疗效果。

Objective： To explore the clinical therapeutic effect ofheterotopic gray matterepileptic with the treatment of y- knife after the localization combined MRI with PET - CT. Methods： During 2008 - O1 - 2011 - 08 6 patients of refractory epilepsy were confirmed heterotopie gray matter by MRI, who were examined by electrophysiology examination and PET - CT scan, according to the strict physical examination and the clinical manifestation during seizures. Aimed to the lumpish or isolated lesions showed by MRI scan, all the patients were treated with y- knife and followed up 4 - 24 months. The therapeutic effect was evaluated with the standard of International League Against Epilepsy. Results： Patient of Grade I wasl case; patient of Grade II were 3 cases ; patient of Grade III wasl case ; patient of Grade IVwas 1 case. The cure rate was 83%. No complications occurred. Conclusion：Through localization combined MRI with PET - CTand synthetic application of various examinations, the treatment of y- knife can not only consumedly improve accuracy of epilepto- genic focusand optimize treatment protocols but also guide clinical therapy and improve therapeutic effect.