动脉自旋标记成像用于平扫MR阴性发作间期癫痫患儿

Arterial spin labeling imaging in interictal epilepsy children with negative plain MR results

目的观察动脉自旋标记(ASL)成像对平扫MR阴性的发作间期癫痫患儿的诊断价值。方法纳入56例平扫MR未显示结构异常的发作间期癫痫患儿,采用视觉分析法将ASL显示灌注异常分为低灌注或高灌注,与临床及视频脑电图(VEEG)定位癫痫灶结果进行一致性检验,并分析ASL异常灌注的影响因素。结果 56例中,52例(52/56,92.86%)为癫痫局灶性发作,4例(4/56,7.14%)为全身性发作。39例(39/56,69.64%)ASL显示灌注异常,37例(37/52,71.15%)为局灶性发作、2例(2/4,50.00%)为全身性发作;其中20例(20/39,51.28%)ASL显示灌注异常定位与临床定位癫痫灶完全一致,9例(9/39,23.08%)部分一致;ASL定位癫痫灶与临床定位结果具有中等一致性(Kappa=0.46,P<0.01)。于发作1天内行ASL是唯一与MR和临床定位癫痫灶一致性相关的因素(P<0.05)[OR=3.81,95%CI(1.16,12.44),P=0.027]。结论 ASL技术可于发作间期有效定位平扫MR阴性癫痫患儿的癫痫灶。

Objective To observe the value of arterial spin labeling(ASL)in children with interictal epilepsy with negative plain MR results.Methods A total of 56 interictal epileptic children with negative plain MR results were included.ASL abnormalities were classified into hypo/hyperperfusion based on visual assessment and compared with the seizure focus determined by clinical data and video-electroencephalography(VEEG).The impact factors of abnormal ASL perfusion were analyzed.Results Among 56 cases,52(52/56,92.86%)had focal seizures and 4(4/56,7.14%)had generalized seizures.Abnormal perfusion changes were found in 39 cases(39/56,69.64%),including 37 cases(37/52,71.15%)of focal seizures and 2 cases(2/4,50.00%)of generalized seizures,among them 20(20/39,51.28%)ASL findings were completely consistent and 9(9/39,23.08%)were partially consistent with clinical localization of epileptic foci.ASL localization of epileptic foci was moderately consistent with clinical localization(Kappa=0.46,P<0.01).ASL acquired within 1 day after seizure was the only factor significantly associated with the consistency of ASL and clinical localization of epileptic foci(OR=3.81,95%CI[1.16,12.44],P=0.027).Conclusion ASL technique could effectively locate interictal epileptic foci in children with negative plain MR results.