PET/MR融合显像在癫痫灶定位中的应用价值

Application Value of the PET Combined with MR Fusion Imaging in Location of Epileptogenic Focus

目的探讨PET/MR融合显像在癫痫灶定位中的价值。方法选择行手术治疗的顽固性癫痫40例,术前均行癫痫发作间期头部18F-FDG PET和MR检查,行术前、术中脑电监测。结果 40例发作间期头部18F-FDGPET检查35例阳性,阳性率为87.5%;MR检查30例阳性,阳性率为75.0%。PET检查与术前脑电监测癫痫灶完全一致率为60.0%,部分一致率为20.0%,MR检查与术前脑电监测癫痫灶完全一致率为40.0%,部分一致率15.0%。PET/MR检查与术前脑电监测癫痫灶完全一致率为80.0%,部分一致率20.0%;PET/MR检查与术中脑电监测癫痫灶位置完全一致率为82.5%,部分一致率为17.5%。40例手术均成功。术后随访2～3年,依据Engle疗效分级标准Ⅰ级33例,Ⅱ级2例,Ⅲ/Ⅳ级5例。结论 PET/MR两种技术在癫痫灶定位中能优势互补,具有无创、高灵敏度的优点。

Objective To explore value of the PET combined with MR fusion imaging in location of epileptogen- ic focus. Methods A total of 40 patients with refractoriness epilepsy were treated with operations. The JSF.FDG PET and MR on head before operation in the period of seizure disorder were performed, and electroencephalogram was also de- tected before and during operation. Results The ~SF_FDG PET examination on head in 40 patients showed that 35 pa- tients were positive, and positive rate was 75.0%. In the examination of MR, 30 patients were tested positive, and the rate of it was 75.0%. The full concordance rate of PET examination and electroencephalogram detection of epileptogenic focus before operation was 60.0% , and the part concordance rate was 20.0%. The full concordance rate of MR examina- tion and electroencephalogram detection of epileptogenic focus before operation was 40.0% , and the part concordance rate was 15.0%. The full concordance rate of PET combined with MR examination and electroencephalogram detection of epileptogenic focus before operation was 80.0% , and the part concordance rate was 20.0%. The full concordance rate of PET combined with MR examination and intraoperative electroencephalogram detection of epileptogenic focus location was 82.5% , and the part concordance rate was 17.5%. The 40 patients had successful operations. With postoperative fol- low-up for 2-3 years, there were 33 patients with grade I , 2 patients with grade lI , and 5 patients with grade m or by the effect standard of Engle. Conclusion PET combined with MR examination in location of epileptogenic focus may mutual complement of advantages with noninvasion and accuracy.