CAJ | 학술논문

目的介绍发作间期 18F-FDG-PET进行颞叶癫痫灶定位的方法,探讨发作间期18F-FDG-PET在颞叶癫痫灶定位中的价值.方法回顾性分析术前行 18F-FDG-PET检查、手术后随访效果达到 Engle Ⅰ级的82例颞叶癫痫患者的临床资料,对 18F-FDG-PET在颞叶癫痫灶中定位敏感率和特异性进行分析,并与脑电图监测和MRI进行比较.结果发作间期 18F-FDG-PET检查中癫痫灶表现为低代谢灶,其中68例位于癫痫灶侧颞叶或以颞叶为主合并其它区域,9例位于癫痫灶侧颞叶以外,5例未见低代谢灶.18F-FDG-PET对癫痫灶定位诊断准确率为82.9%(68/82),显著优于MRI和脑电图(P＜0.05),且在MRI阴性和需要埋置电极进行脑电图检查定位的患者中分别有77.4%(41/53)和75%(15/20)可以达到准确的定位癫痫灶.病理阳性者18F-FDG-PET定位准确率显著高于病理阴性者(P＜0.05).结论 18F-FDG-PET定位颞叶癫痫灶具有高敏感性、高特异性的特点,对MRl阴性和需要埋置电极进行检查的颞叶癫痫灶也有良好的定位价值,合理的应用还可能进一步提高结果.
목적 개소발작간기 18F-FDG-PET진행섭협전간조정위적방법,탐토발작간기18F-FDG-PET재섭협전간조정위중적개치.방법 회고성분석술전행 18F-FDG-PET검사、수술후수방효과체도 Engle Ⅰ급적82례섭협전간환자적림상자료,대 18F-FDG-PET재섭협전간조중정위민감솔화특이성진행분석,병여뇌전도감측화MRI진행비교.결과 발작간기 18F-FDG-PET검사중전간조표현위저대사조,기중68례위우전간조측섭협혹이섭협위주합병기타구역,9례위우전간조측섭협이외,5례미견저대사조.18F-FDG-PET대전간조정위진단준학솔위82.9%(68/82),현저우우MRI화뇌전도(P＜0.05),차재MRI음성화수요매치전겁진행뇌전도검사정위적환자중분별유77.4%(41/53)화75%(15/20)가이체도준학적정위전간조.병리양성자18F-FDG-PET정위준학솔현저고우병리음성자(P＜0.05).결론 18F-FDG-PET정위섭협전간조구유고민감성、고특이성적특점,대MRl음성화수요매치전겁진행검사적섭협전간조야유량호적정위개치,합리적응용환가능진일보제고결과.
Objective To introduce the technique of interictal 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) examination and explore the value of 18F-FDG-PET in the localization of epileptogenic focus of temporal lobe epilepsy (TLE) confirmed by surgical result.Methods Clinical data were retrospectively analyzed in 82 TLE patients having received interictal 18F-FDG-PET preoperative evaluation and got EngleⅠ grade epileptic surgical outcome, and the sensitivity and specialty of interictal 18F-FDG-PET were compared with those of MRI and scalp video-EEG. Results Epileptogenic foci showed hypometabolism on 18F-FDG-PET, and the hypometabolism zones were localized in ipsilateral temporal lobe in 68 cases,beyond ipsilateral temporal lobe in 9 cases; the other 5 had no hypometabolism zone. Accuracy rate of localization of epileptogenic foci by interictal 18F-FDG-PET was 82.9% (68/82), significantly higher than that by MRI or EEG(P＜0.05).77.4%(41/53)epileptogenic foci where MRI showed negative and 75%(15/20)where EEG with imbedded electrode was applied were precisely localized by 18F-FDG-PET. The accuracy was higher in the cases with positive pathological result than in the ones with negative result. Conclusions Interictal 18F-FDG-PET possesses excellent sensitivity and specialty in preopemtive assessment for TLE, and is of good value in the localization of epileptogenic focus where MRI shows negative or invasive electrophysiologic monitoring is needed.Rational application may raise the accuracy rate.