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目的:评价脑磁图(MEG)在耐药性癫癎术前定位中的价值并探讨影响其定位的因素。方法:在47例术前均行MEG,VEEG,MRI检查的耐药性癫癎病例中,以术中皮层脑电图(ECoG)为金标准,比较VEEG和MEG定位准确性,并作影响MEG和VEEG定位的logistic多因素分析。结果:47例颞叶癫癎中,MEG与ECoG完全吻合32例(68％),部分吻合8例(17％);VEEG与ECoG完全吻合18例(38％),部分吻合23例(49％)。MEG与ECoG完全吻合病例明显多于MEG与VEEG吻合例(P <0．05)。MEG定位的多因素分析显示发作频率对MEG定位有影响(P<0．05)。结论:MEG的应用有助于致癎灶的准确定位和手术方式的选择,在难治性颞叶癫癎的术前定位中有重要的临床应用价值。
Objective: To evaluate the value of magnetoencephalography (MEG) in the preoperative localization of drug resistant epilepsy and to explore the factors that affect its location. Methods: In the 47 cases of drug-resistant epilepsy with MEG, VEEG and MRI examinations before operation, the intracortical EEG (ECoG) was used as the gold standard to compare the accuracy of VEEG and MEG positioning and to evaluate the effect of MEG And logistic multivariate analysis of VEEG localization. Results: In 47 cases of temporal lobe epilepsy, MEG was completely consistent with ECoG in 32 cases (68%) and partial coincidence in 8 cases (17%). VEEG was completely consistent with ECoG in 18 cases (38%) and partial coincidence in 23 cases (49% ). The complete agreement between MEG and ECoG was significantly more than that between MEG and VEEG (P <0.05). Multivariate analysis of MEG localization showed that seizure frequency had an effect on MEG localization (P <0.05). Conclusion: The application of MEG is helpful to the accurate localization of the foci and the choice of the surgical procedure. It has important clinical value in preoperative localization of intractable temporal lobe epilepsy.