CAJ | 학술논문

目的评价正电子发射计算机断层(PET)在MRI阴性致痫灶定位诊断中的意义.方法对61例癫痫患者行头MRI、视频脑电图(VEEG)和发作间期18 F-FDG联合13N-NH3·H2O-PET检查,将MRI阴性手术患者术前定位与术后疗效比较,并对MRI阳性与MRI阴性两组间PET、VEEG结果进行比较.结果 MRI阴性组26例,阳性组35例；VEEG定位致痫灶提示:脑区性12例,多脑区性16例,半球性13例,不能定位20例；PET显像61例均有异常改变:脑区性23例,多脑区性28例,半球性5例,不能定位6例.17例MRI阴性患者术后Engels标准达Ⅰ～Ⅱ级的12例占70.59％,对两组间PET、VEEG定位分别进行比较,差异均无统计学意义；分别对两组的PET与VEEG比较,差异均有统计学意义.结论 PET是一种对致痫灶定位敏感性、准确性较高的功能影像检查技术,特别在MRI阴性时,PET是定位致痫灶必不可少的检查手段.
목적 평개정전자발사계산궤단층(PET)재MRI음성치간조정위진단중적의의.방법 대61례전간환자행두MRI、시빈뇌전도(VEEG)화발작간기18 F-FDG연합13N-NH3·H2O-PET검사,장MRI음성수술환자술전정위여술후료효비교,병대MRI양성여MRI음성량조간PET、VEEG결과진행비교.결과 MRI음성조26례,양성조35례；VEEG정위치간조제시:뇌구성12례,다뇌구성16례,반구성13례,불능정위20례；PET현상61례균유이상개변:뇌구성23례,다뇌구성28례,반구성5례,불능정위6례.17례MRI음성환자술후Engels표준체Ⅰ～Ⅱ급적12례점70.59％,대량조간PET、VEEG정위분별진행비교,차이균무통계학의의；분별대량조적PET여VEEG비교,차이균유통계학의의.결론 PET시일충대치간조정위민감성、준학성교고적공능영상검사기술,특별재MRI음성시,PET시정위치간조필불가소적검사수단.
Objective To explore the application value of positron emission tomography (PET) in the localization of magnetic resonance imaging ( MRI)-negative epileptogenic focus.Methods Brain images of 18fluoro-2-deoxy-D-glucose ( 18 F-FDG) and 13 N-NH3· H2O-PET,MRI and video electroencephalography (VEEG) were obtained in 65 patients.Preoperative and postoperative localizations were compared in MRI-negative patients.And the results of PET and VEEG were compared between the MRI-positive and MRI-negative groups.Results MRI scans were normal in 26 cases and abnormal in 35 cases.Sixty-one patients had interictal epileptiform discharge on VEEG (brain regions,n =12; multiple brain areas,n =16;hemisphere,n =13; unspecified location,n =20) and interictal PET imaging (brain regions,n =23;multiple brain areas,n =28 ; hemisphere,n =5 ; unspecified location,n =6). And 17 MRI-negative patients underwent operations and 12 of them reached the Engels Ⅰ - Ⅱ level standard. Both PET and VEEG were compared between the MRI-positive and MRI-negative groups.No significant differences existed between two group (P ＜ 0.05).A comparison of PET and VEEG showed statistical significance in two group (P ＞ 0.05).Conclusion PET imaging is both sensitive and effective in the detection and localization of epileptogenic foci.Especially for MRI-negative cases,it is an indispensable tool of localizing epileptogenic foci.