PET辅助定位脑软化灶伴发难治性癫痫的伽玛刀治疗  

Value of PET-assisted localization of foci for encephalomalacia complicated with refractory epilepsy and significance ofγ-knife treatment

作　　者：刘琨[1] 王国栋[2] 张静华[1] 苗丽[3] 于青[1] 赵相立[1] 陈冬云[1] 聂斐[1] 

机构地区：[1]山东省济宁医学院第二附属医院神经外科伽玛刀治疗中心,济宁272051 [2]山东省立医院神经外科,济南250021 [3]深圳市罗湖人民医院伽玛刀治疗心,518001

出　　处：《中华神经医学杂志》2007年第12期1260-1264,共5页Chinese Journal of Neuromedicine

摘　　要：目的探讨正电子发射断层扫描(PET)对脑软化灶伴有难治性癫痫的定位价值和γ-刀治疗的效果。方法对18例脑软化灶伴有难治性癫痫的患者进行PET检查,根据PET检查结果并结合MRI、CT、视频脑电图、VEEG及临床表现确定放射治疗靶区。结果14例致痫灶位于脑软化病灶周围的皮层组织,4例致痫灶不仅位于脑软化病灶周围,还位于其他脑叶或远隔部位。18例经γ-刀治疗后随访12～48个月,平均16个月,满意8例,显著改善5例,良好3例,无效2例,有效率88.9%(16/18)。均未见新的并发症发生。结论对脑软化灶伴有难治性癫痫发作患者行PET检查定位致痫灶,有助于选择γ-刀治疗方案,提高γ-刀治疗效果。Objective To evaluate the localization value of positron emission tomography （PET） for patients suffering from cnccphalomalacia complicated with refractory epilepsy and the curative effect of γ-knifc treatment. Methods The PET examination was performed on 18 cases suffering from cnccpbalomalacia complicated with refractory epilepsy, and the target volume for radiosurgcry was determined through the combination of the results for the PEI examination, manifestations of magnetic resonance imaging （MPA）, computed tomograpby （CT） and video-electroencephalogram （VEEG） and clinical representations. Results Epilcptogcnic loci for 14 cases wcrc located in the cortical tissue around cnccpbalomalacia loci; cpilcptogcnic loci for 4 cases wcrc not only located around cnccphalomalacia loci but also in other cerebral lobes or distal sites. Among the 18 cases who had undergone γ-knifc treatment and wcrc follow up for 12-48 months, 16 months on average, 8 wcrc satisfactory, 5 wcrc significantly ameliorated, 3 wcrc benign and 2 wcrc ineffective; the effective rate was 88.9%（16/18）. No new complications occurred. Conclusion The PET examination is precise for the localization of cpilcptogcnic loci in patients suffering from cnccphalomalacia complicated with refractory epilepsy, which shall bc helpful for the selection of T-knife treatment programs and further enhance the curative effect of this treatment.

关 键 词：脑软化灶 癫痫 伽玛刀 PET 靶区 

分 类 号：R742.1[医药卫生—神经病学与精神病学]