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目的 :比较顽固性癫患者的正电子发射计算机断层扫描 (PET)、脑电图 (EEG)、磁共振成像 (MRI)结果 ,探讨脱氧葡萄糖 (18F FDG)PET对致灶进行定位的可行性和应用价值。方法 :10 2例顽固性癫患者 (男 6 4例 ,女 38例 ,平均年龄 2 2 1岁 )进行18F FDGPET脑显像 ,发作期显像 5例 ,发作间期显像 97例 ,全部病例均行EEG检查 ,4 8例作过MRI检查 ,分析比较PET、EEG和MRI定位致灶的有效性。结果 :PET发作期显像主要为局部高代谢 ,发作间期显像为 1个或多个低代谢灶 ,阳性检出率为92 4 % ,定侧定位率 5 2 9% ,PET对致灶的检出率和定侧定位率均明显高于EEG和MRI(P <0 0 1) ;EEG与PET检出的符合率为 4 1 2 % ,MRI与PET检出的符合率 4 1 7%。结论 :癫患者18F FDGPET脑显像是一种敏感而安全的定位顽固性癫致灶的有效方法 ,明显优于EEG和MRI,但PET所示异常低代谢区是否均为致灶尚存在质疑 ,联合EEG和MRI可提高灶检出阳性率及定位准确性。
Objective: To compare positron emission computed tomography (PET), electroencephalogram (EEG) and magnetic resonance imaging (MRI) results of patients with intractable epilepsy to investigate the feasibility of using deoxyglucose (18F FDG) PET to locate the foci Sex and application value. Methods: Ten patients with refractory epilepsy (64 males and 38 females with an average age of 2121) were enrolled in this study. 18F FDG PETET scintigraphy was performed in 5 patients with episodes of epilepsy and 97 patients with interictal seizures EEG examination was performed in all cases, and 48 cases were examined by MRI. The effectiveness of PET, EEG and MRI in the diagnosis of foci were analyzed. Results: The onset of PET was mainly localized hypermetabolism with one or more low metabolic lesions in the interictal seizure. The positive detection rate was 92.4% and the fixed orientation rate was 52.9% The foci detection rate and fixation rate were significantly higher than that of EEG and MRI (P <0.01). The coincidence rate of EEG and PET was 41.2%, and the coincidence rate of MRI and PET was 41.7 %. Conclusion: 18F FDG PET brain imaging in patients with epilepsy is a sensitive and safe method for locating intractable epilepsy induced focal lesions, which is obviously better than EEG and MRI. However, There are still questions, combined EEG and MRI can improve the positive rate of detection of foci and positioning accuracy.