统计参数图用于^(18)F-FDGPET定位局灶性脑皮层发育不良所致难治性癫痫致痫灶

Statistical parametric mapping on ^(18)F-FDG PET in localizing lesions of intractable epilepsy induced by focal cortical dysplasia

目的探讨统计参数图(SPM)用于18F-FDG PET术前定位局灶性脑皮层发育不良(FCD)所致难治性癫痫致痫灶的价值。方法收集经病理诊断和术后证实为FCD致痫性难治性癫痫患者34例,于其术前癫痫发作间期行18FFDG PET显像,分别采用视觉分析法和SPM分析法对PET图像进行术前致痫灶定位诊断和定侧诊断,比较两种方法对FCD致痫灶检出率和定侧诊断正确率的差异。结果 34例患者经术后病理及随访共证实41个FCD致痫灶,视觉分析法检出率为70.73%(29/41),SPM分析法检出率78.05%(32/41),两种方法检出率差异无统计学意义(χ2=0.576,P=0.448)。对致痫灶进行定侧诊断时,视觉分析法定侧诊断正确率为67.65%(23/34),SPM法为91.18%(31/34),差异有统计学意义(P=0.033)。结论 SPM分析法对FCD致痫灶检出率与视觉分析法无显著差异,其对致痫灶的定侧诊断效能优于视觉分析法。

Objective To investigate the value of statistical parametric mapping（SPM）on 18F-FDG PET in preoperative localization of focal cortical dysplasia（FCD）epileptic foci.Methods Totally 34patients with intractable epilepsy caused by FCD confirmed with surgical pathology were enrolled.All patients underwent 18F-FDG PET before surgery.PET images were analyzed with visual analysis method and SPM analysis method respectively.The detection rate of localization of epileptic foci and the accuracy rate of side diagnosis were compared between the two methods,respectively.Results According to the results of pathology and following-up survey,totally 41epileptic foci of FCD were found in 34patients.The detection rate of visual analysis method and SPM analysis method was 70.73%（29/41）and 78.05%（32/41）,respectively（χ2=0.576,P=0.448）.In addition,the accuracy rate of side diagnosis of visual analysis method was67.65%（23/34）,while of SPM analysis method was 91.18%（31/34）,and the difference was statistically significant（P=0.033）.Conclusion SPM analysis method is not significant different with visual analysis method in the detection rate of FCD epileptic foci,but is superior to visual analysis method in preoperative localization of the side of FCD epileptic foci.