18F-FDG PET/CT显像在难治性癫痫患儿诊断中的应用

Application of 18F-FDG PET/CT in the diagnosis of children with intractable epilepsy

目的分析氟脱氧葡萄糖18F(18F-FDG)正电子发射计算机断层(PET/CT)显像在难治性癫痫患儿诊断中的应用价值。方法回顾性分析2008年1月至2018年12月期间西安高新医院收治的305例难治性癫痫患儿的临床资料,所有患儿均行18F-FDG PET/CT检查。根据患儿年龄分为低龄组112例、中龄组90例和大龄组103例,并根据单侧大脑皮层异常累及脑叶数目分为轻度组123例和重度组139例。分析不同组别患者大脑皮层下结构代谢异常发生率。结果低龄组、中龄组、大龄组患儿大脑皮层下基底核(11.61%、8.89%、9.71%)、丘脑(17.86%、15.56%、19.42%)、小脑(17.86%、13.33%、22.33%)的结构代谢异常发生率比较差异均无统计学意义(P>0.05);单侧大脑皮层病变轻度组皮层下基底核、丘脑、小脑结构代谢异常发生率分别为2.43%、8.13%、12.20%,明显低于重度组的20.14%、31.65%、25.90%,差异均具有统计学意义(P<0.05)。结论18F-FDG PET/CT在难治性癫痫患儿诊断中可及时发现大脑皮层下结构代谢异常,有助于确定皮层病灶累及范围。

Objective To analyze the application of fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography(18F-FDG PET/CT)in the diagnosis of children with intractable epilepsy.Methods The clinical data of 305 children with refractory epilepsy,who admitted to Xi'an Gaoxin Hospital from January 2008 to December 2018,were retrospectively analyzed.All children underwent 18F-FDG PET/CT examination.According to the age of the children,they were divided into low age group(112 cases),middle age group(90 cases),and old age group(103 cases).According to the number of lobes involved in unilateral cerebral cortex abnormalities,they were divided into mild group(123 cases)and severe group(139 cases).The abnormal rate of subcortical structure metabolism in different groups was analyzed.Results There was no significant difference in the incidence of structural metabolic abnormalities in the subcortical basal nucleus(11.61%vs 8.89%vs 9.71%),thalamus(17.86%vs 15.56%vs 19.42%),cerebellum(17.86%vs 13.33%vs 22.33%)among the young,middle and old groups(all P>0.05);the incidences of abnormal metabolism in subcortical basal nucleus,thalamus,and cerebellum in mild group were 2.43%,8.13%,and 12.20%,respectively,which were significantly lower than corresponding 20.14%,31.65%,and 25.90%in severe group(all P<0.05).Conclusion 18F-FDG PET/CT is effective in the diagnosis of children with intractable epilepsy.It can detect the abnormal metabolism of subcortical structure in time and help to determine the involvement of cortical lesions.