PET-CT、核磁共振及VEEG对难治性癫痫的诊断及致痫灶术前定位研究

发布时间：2018-07-20 18:19

【摘要】：目的:探讨PET-CT、核磁共振（MRI）、视频脑电图（VEEG）及其联合应用在难治性癫痫手术术前诊断及致痫灶定位评估中的价值。 方法：回顾性收集我院神经外科自2010年1月至2013年12月行手术治疗的难治性癫痫患者的临床资料，，包括病史、临床症状、视频脑电图、术前核磁、PET-CT及术中ECoG检查结果。术后随访复查，评估癫痫Engle预后分级。根据癫痫Engle预后分级及ECoG定位结果，分析评估PET-CT、MRI及VEEG对致痫灶的定位价值。 结果：本组19例患者全部行MRI及VEEG检查，6例因MRI阴性或症状定位、影像定位与脑电定位结果不符行PET-CT检查，全部患者在ECoG监测下行手术治疗。借助VEEG、MRI联合症状学准确定位致痫灶13例，PET-CT联合VEEG、症状学准确定位致痫灶4例，PET-CT联合MRI、症状学准确定位致痫灶2例。术后随访0.5~2年，癫痫Engle预后分级：Ⅰ级12例，Ⅱ级5例，Ⅲ级2例。 结论: VEEG及MRI可作为难治性癫痫术前定位评估最基本的检查方式；当MRI阴性或症状定位、影像学定位与脑电定位不符时，建议行PET-CT检查。
[Abstract]:Objective: to evaluate the value of PET-CTMRI video electroencephalogram (VEEG) and its combined application in preoperative diagnosis and location evaluation of epileptogenic foci after intractable epilepsy surgery. Methods: the clinical data of patients with intractable epilepsy who underwent surgical treatment in neurosurgery from January 2010 to December 2013 were retrospectively collected, including medical history, clinical symptoms, video EEG, preoperative PET-CT and intraoperative ECoG examination. The prognosis of Epilepsy Engle was evaluated by follow-up and reexamination. The value of PET-CTT MRI and VEEG in the localization of epileptogenic foci was analyzed and evaluated according to ECoG localization and Engle grade of epilepsy. Results: all the 19 patients underwent MRI and VEEG examination, 6 cases were negative or symptomatic localization of MRI, the imaging localization was not consistent with EEG localization. All the patients underwent PET-CT under ECoG monitoring. 13 cases of epileptic foci were accurately located by VEEGT MRI combined with symptomatology, 4 cases by SET-CT combined with MRI, 2 cases by symptomatic localization of epileptic foci. Follow-up for 0.5 ~ 2 years showed that 12 cases were grade 鈪

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