SPECT脑血流灌注显像在癫痫病灶定位诊断中的价值——与CT,MRI及EEG检查对比分析  

The Diagnostic Value of rCBF Brain SPECT in Localization of Epileptic Foci:In Comparison with X-ray CT,MRI and EEG Findings

作　　者：魏学立[1,2] 林伟[1,2] 欧阳智[1,2] 叶广春[1,2] 邬恒夫[1,2] 武兆忠[1,2] 朱德仪[1,2] 高聪[1,2] 熊希民[1,2] 

机构地区：[1]广州医学院附属二院核医学科 [2]广州医学院神经科学研究所

出　　处：《临床医学影像杂志》1997年第4期265-267,共3页

摘　　要：目的：评价ＳＰＥＣＴ脑血流灌注显像在癫痫病灶定位诊断中的价值。方法：对９６例癫痫间歇期、１３例发作期患者进行了ＳＰＥＣＴ脑血流灌注显像，９３例作了ＥＥＧ检查，７４例作了脑ＣＴ检查，２５例作了ＭＲＩ检查。并对各种检测的结果进行比较。结果：ＳＰＥＣＴ脑血流灌注显像对癫痫病灶的检出阳性率为９７２５％，其它方法检出的阳性率ＥＥＧ为８６０２％，ＭＲＩ为３６％，ＣＴ为２７０３％。ＳＰＥＣＴ与ＥＥＧ阳性检出符合率为８３８７％。ＣＴ、ＭＲＩ和ＳＰＥＣＴ检出的病灶部位符合率分别为６２５％和５６％。ＳＰＥＣＴ脑血流灌注显像检出的癫痫病灶８５％分布在大脑颞叶、额叶和顶叶。５５％以上的癫痫患者有２个或２个以上的癫痫灶。结论：ＳＰＥＣＴ脑血流灌注显像是诊断癫痫病灶的灵敏而有效的方法，对制定癫痫的手术或γ刀治疗方案具有重要意义，其对癫痫病灶的定位价值优于ＥＥＧ、ＭＲＩ和ＣＴ。PURPOSE:To evaluate the diagnostic value of rCBF Brain SPECT in localization of Epileptic Foci METHODS:rCBF Brain SPECT with99mTc-ECD was performed in 96 patients with interictal epilepsy and 13 patients with epilepsy seizure, EEG was performed in 93, CT in 74 and MRI in 25. All the results were compared with each other. RESULTS:The highest positive rate(97.25%)was found in rCBF Brain SPECT. The finding positive rate with rCBF Brain SPECT was in concordance with EEG in 83.87%. The localization of epileptic foci with CT or MRI was in concordance with rCBF Brain SPECT in 62.5% or 56%. The finding epileptic foci with rCBF Brain SPECT was distributed mainly(85%) over temporal lobe, frontal lobe and parietal lobe. Over 55% of epileptic patients had two or more epileptic foci. CONCLUSIONS:rCBF Brain SPECT is a sensitive and effective method for epileptic foci localization. It may have the advantage in detecting and localizing epileptic foci of EEG,MRI and CT. It may be also helpful in preparing a reasonable operative of γ -knife therapeutical protocol for a special epileptic patient.

关 键 词：癫痫 脑 局部血流 断层摄影术 诊断 

分 类 号：R742.104[医药卫生—神经病学与精神病学]