中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2013年
12期
1224-1227
,共4页
郭韬%孙吉林%吴育锦%杜亚丽
郭韜%孫吉林%吳育錦%杜亞麗
곽도%손길림%오육금%두아려
视频脑电图%脑磁图%弥散张量成像%局灶性皮质发育不良%诊断%定位
視頻腦電圖%腦磁圖%瀰散張量成像%跼竈性皮質髮育不良%診斷%定位
시빈뇌전도%뇌자도%미산장량성상%국조성피질발육불량%진단%정위
Video electroencephalogram%Magnetoencephalography%Diffusion tensor imaging%Focal cortical dysplasias%Diagnosis%Localization
目的 探讨常规影像学难以确诊的额叶癫痫的诊断和定位方法,为手术治疗提供依据.方法 回顾分析联合应用视频脑电图(VEEG)、脑磁图(MEG)、弥散张量成像(DTI)检查,诊断、定位并经手术证实为皮质发育不良(FCD)的28例常规影像学难以确诊的额叶癫痫患者的临床资料.结果 VEEG显示棘波灶与FCD有很好的重叠性;阵发性或节律性的棘波活动高度提示FCD.MEG提示FCD位置及与功能区的关系,明确DTI感兴趣区(ROI).DTI根据R01的表观弥散系数图和部分各向异性图变化,确定常规影像学难以确诊的额叶癫痫的手术范围.28例癫痫患者行手术治疗,病理回报FCD Ⅰ a型6例,FCD Ⅰ b型9例,FCD Ⅰ c型8例,FCDⅡa型5例.全部患者术后随访12～26个月,平均17.3个月.Engel Ⅰ a级7例,Ⅰb级10例,Ⅱ级8例,Ⅲ级3例.结论 联合应用VEEG、MEG和DTI技术可以准确诊断、定位常规影像学难以确诊的额叶癫痫,为精确切除致痫灶,提高额叶癫痫控制率提供保障.
目的 探討常規影像學難以確診的額葉癲癇的診斷和定位方法,為手術治療提供依據.方法 迴顧分析聯閤應用視頻腦電圖(VEEG)、腦磁圖(MEG)、瀰散張量成像(DTI)檢查,診斷、定位併經手術證實為皮質髮育不良(FCD)的28例常規影像學難以確診的額葉癲癇患者的臨床資料.結果 VEEG顯示棘波竈與FCD有很好的重疊性;陣髮性或節律性的棘波活動高度提示FCD.MEG提示FCD位置及與功能區的關繫,明確DTI感興趣區(ROI).DTI根據R01的錶觀瀰散繫數圖和部分各嚮異性圖變化,確定常規影像學難以確診的額葉癲癇的手術範圍.28例癲癇患者行手術治療,病理迴報FCD Ⅰ a型6例,FCD Ⅰ b型9例,FCD Ⅰ c型8例,FCDⅡa型5例.全部患者術後隨訪12～26箇月,平均17.3箇月.Engel Ⅰ a級7例,Ⅰb級10例,Ⅱ級8例,Ⅲ級3例.結論 聯閤應用VEEG、MEG和DTI技術可以準確診斷、定位常規影像學難以確診的額葉癲癇,為精確切除緻癇竈,提高額葉癲癇控製率提供保障.
목적 탐토상규영상학난이학진적액협전간적진단화정위방법,위수술치료제공의거.방법 회고분석연합응용시빈뇌전도(VEEG)、뇌자도(MEG)、미산장량성상(DTI)검사,진단、정위병경수술증실위피질발육불량(FCD)적28례상규영상학난이학진적액협전간환자적림상자료.결과 VEEG현시극파조여FCD유흔호적중첩성;진발성혹절률성적극파활동고도제시FCD.MEG제시FCD위치급여공능구적관계,명학DTI감흥취구(ROI).DTI근거R01적표관미산계수도화부분각향이성도변화,학정상규영상학난이학진적액협전간적수술범위.28례전간환자행수술치료,병리회보FCD Ⅰ a형6례,FCD Ⅰ b형9례,FCD Ⅰ c형8례,FCDⅡa형5례.전부환자술후수방12～26개월,평균17.3개월.Engel Ⅰ a급7례,Ⅰb급10례,Ⅱ급8례,Ⅲ급3례.결론 연합응용VEEG、MEG화DTI기술가이준학진단、정위상규영상학난이학진적액협전간,위정학절제치간조,제고액협전간공제솔제공보장.
Objective To investigate the method of diagnosis and localization for negative imaging frontal lobe epilepsy,and provide the basis for the surgical treatment.Methods Retrospective analysis of the clinical data in 28 patients with diagnosis and localization for negative imaging frontal lobe epilepsy by video electroencephalogram (VEEG),magnetoencephalography (MEG) and diffusion trnsor imaging (DTI),and FCD were proved by operation.Results The scope of FCD overlaps the area of spike wave by VEEG showed the area of spike wave with paroxysmal and rhythmicity that it would probably FCD.MEG indicate the relationship between FCD and functional cortex,also confirm regionofinterest of DTI.DTI can according to the changes of apparent diffusion coefficient map (ADC) and fractional anisotropy maps (FA),determine the surgical treatment range of nonlesional frontal lobe epilepsy.28 patients of epilepsy treated by operation,pathological report shows 6 cases of FCD type Ⅰ a,9 cases of FCD type Ⅰ b,8 cases of FCD type Ⅰ c,5 cases of FCD type Ⅱ a.All patients were followed up for 12 to 26 months,an average of 17.3 months.Engel Ⅰ grade A in 7 cases,10 cases of Engel Ⅰ grade B,8 cases of grade Ⅱ,3 cases in grade Ⅲ.Conclusions Combined application of VEEG,MEG and DTI technology can accurately diagnose and location for negative imaging frontal lobe epilepsy,they also guide the precise excision of epileptogenic focus and improve the control rate of frontal lobe epilepsy.
