MRI和CT联合定位诊断22例癫痫的价值及影像特征分析

Value and Imaging Features of MRI and CT in Localization Diagnosis of 22 Cases of Epilepsy

目的探讨MRI和CT联合定位诊断22例癫痫的价值及影像特征分析。方法选择2016年6月至2018年6月在我院神经外科就诊的癫痫患者66例进行回顾性分析,其中22例进行MRI和CT诊断,观察两种诊断方式的影像学特征及联合诊断与术中皮质脑电图(ECoG)诊断符合率。结果 66例病人MRI检查结果12例为单纯海马萎缩硬化,10例为单纯杏仁核信号增强,海马硬化合并其他病变中脑萎缩、软化灶病变较为常见,其他病变中胶质增生较为常见,且18例患者MRI检查结果无异常。22例患者进行PET-CT检查,其中常见病灶部位为单侧广泛代谢区7例。MRI、PET-CT联合检查与术中ECoC检查符合率72.73%,进行卡方检验差异有统计学意义(P<0.05)。结论 MRI和CT诊断定位部位各不相同,其中MRI对海马/杏仁核诊断较为可靠,CT可以提供更多定位信息,两者优势互补,联合检查符合率较高。

Objective To investigate the value and imaging features of MRI and CT in localization diagnosis of 22 patients with epilepsy. Methods A retrospective analysis was performed on 66 patients with epilepsy who were treated in neurosurgery department of the hospital during the period from June 2016 to June 2018. Twenty-two patients were diagnosed by MRI and CT. Imaging features of the two diagnostic methods and the coincidence rate of combined diagnosis with electrocorticography(ECoG) were observed. Results Of the 66 patients, MRI showed that 12 patients had simple hippocampal atrophy and sclerosis, and 10 patients had simple enhanced signal of amygdala. For hippocampal sclerosis combined with other lesions, brain atrophy and softening lesions were more common. Glial hyperplasia was more common in other lesions. There were no abnormalities in MRI findings of 18 patients. Twenty-two patients underwent PET-CT, and the common lesions were located at unilateral extensive metabolism zone of 7 patients. The coincidence rate of MRI combined with PET-CT with intraoperative ECoC was 72.73%. Chi-square test showed that the difference was statistically significant(P<0.05). Conclusion The location of MRI and CT diagnosis is different. MRI is more reliable for the diagnosis of hippocampus/amygdala. CT can provide more localization information. The advantages of the two are complementary, and the coincidence rate of combined examination is higher.