中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2012年
4期
386-388
,共3页
丁虎%乔慧%白勤%史增敏%王冯彬%舒宁%孟凡刚
丁虎%喬慧%白勤%史增敏%王馮彬%舒寧%孟凡剛
정호%교혜%백근%사증민%왕풍빈%서저%맹범강
脑磁图%颅内电极脑电图%癫痫%外科手术
腦磁圖%顱內電極腦電圖%癲癇%外科手術
뇌자도%로내전겁뇌전도%전간%외과수술
Magnetoencephalography%Intracranial electroencephalography%Epilepsy%Surgery
目的 通过研究脑磁图(MEG)对侵入性颅内电极脑电图(icEEG)中电极埋置策略的影响,评价MEG在癫痫外科术前评估中的应用价值.方法 收集83例经临床发作症状学、电生理及影像学诊断为难治性部分性癫痫患者,根据MEG是否参与评估电极埋置策略分为两组,比较两组手术疗效的差异.手术疗效按照Engel疗效评价标准分级,Engel Ⅰ、Ⅱ、Ⅲ级为手术有效,Engel Ⅳ级为手术无效.结果 两组中,MEG未参与电极埋置策略评估的共43例,术后有效23例,占54%;而MEG参与评估电极埋置策略的共40例,术后有效31例,占78%,两组手术疗效差异有统计学意义(x2=5.256,P=0.022).结论 MEG能够指导电极埋置位置,增加发作起始区被电极覆盖的几率,提高颅内电极脑电监测的定位准确率,从而提高手术疗效.
目的 通過研究腦磁圖(MEG)對侵入性顱內電極腦電圖(icEEG)中電極埋置策略的影響,評價MEG在癲癇外科術前評估中的應用價值.方法 收集83例經臨床髮作癥狀學、電生理及影像學診斷為難治性部分性癲癇患者,根據MEG是否參與評估電極埋置策略分為兩組,比較兩組手術療效的差異.手術療效按照Engel療效評價標準分級,Engel Ⅰ、Ⅱ、Ⅲ級為手術有效,Engel Ⅳ級為手術無效.結果 兩組中,MEG未參與電極埋置策略評估的共43例,術後有效23例,佔54%;而MEG參與評估電極埋置策略的共40例,術後有效31例,佔78%,兩組手術療效差異有統計學意義(x2=5.256,P=0.022).結論 MEG能夠指導電極埋置位置,增加髮作起始區被電極覆蓋的幾率,提高顱內電極腦電鑑測的定位準確率,從而提高手術療效.
목적 통과연구뇌자도(MEG)대침입성로내전겁뇌전도(icEEG)중전겁매치책략적영향,평개MEG재전간외과술전평고중적응용개치.방법 수집83례경림상발작증상학、전생리급영상학진단위난치성부분성전간환자,근거MEG시부삼여평고전겁매치책략분위량조,비교량조수술료효적차이.수술료효안조Engel료효평개표준분급,Engel Ⅰ、Ⅱ、Ⅲ급위수술유효,Engel Ⅳ급위수술무효.결과 량조중,MEG미삼여전겁매치책략평고적공43례,술후유효23례,점54%;이MEG삼여평고전겁매치책략적공40례,술후유효31례,점78%,량조수술료효차이유통계학의의(x2=5.256,P=0.022).결론 MEG능구지도전겁매치위치,증가발작기시구피전겁복개적궤솔,제고로내전겁뇌전감측적정위준학솔,종이제고수술료효.
Objective To study whether magnetoencephalography (MEG) could indicate intracranial electroencephalography(icEEG) by affecting electrode placement and localization of the seizure onset zone,and then improve the curative effect of the surgical patients of refractory partial epilepsy.Methods Of all consecutive epilepsy surgery candidates between 2009 -2010,83 cases who meet the refractory partial epilepsy diagnostic criteria were prospectively enrolled in this research.The 83 patients were randomly divided into two groups.In one group (MEG + icEEG group),including 43 patients,the MEG results were provided to affect the initial intracranial electrodes placement decision which was based on case -history,semilogy,EEG,MRI.By contrast,for the other group(icEEG group),including 40 patients,the MEG localization results were not provided.All patients underwent epileptogenic foci surgical resection.The follow-up was performed at least 12 months after the operation.The surgical outcome was evaluated by Engel curative effect grading.Engel Ⅰ,Ⅱ,Ⅲ was defined as effectiv whereas Engel Ⅳ was recognized as invalid.Results According to the surgical outcome of icEEG group,23 patients (54%) obtained good postsurgical seizure outcome.While in MEG + icEEG group,the rate was 78% (31/40).There was statistically significant difference between the two groups(x2 =5.256,P =0.022).Conclusions MEG spike localization could affect icEEG by indicating the electrodes placement,increasing the chance that the seizure onset zone is sampled and improving diagnostic yield of icEEG when patients undergo icEEG for presurgical epilepsy evaluations,finally promote the effectiveness of the surgical resection.