PET/CT在非病灶性癫癎外科评估中的作用  

Role of PET/CT for presurgical evaluation of non-lesional refractory epilepsy

作　　者：常鹏飞[1] 苏崇德[2] 梁英魁[3] 

机构地区：[1]首都医科大学宣武医院功能神经外科,100053 [2]空军航空医学研究所附属医院癫癎中心 [3]海军总医院PET/CT中心

出　　处：《临床神经外科杂志》2011年第3期124-127,共4页Journal of Clinical Neurosurgery

摘　　要：目的探索PET/CT在癫癎外科评估中的作用,更好地利用PET/CT以提高癫癎外科的治疗水平。方法总结分析已经进行手术治疗的难治性局灶性癫癎46例。所有病例在术前都经PET/CT检查(发作间期),并随访6～24个月。结果颞叶癫癎24例PET/CT阳性,与头皮EEG结果、MRI及颅内电极检查结果有高度的一致性;24例均行颞前叶海马切除术,结果 Engel Ⅰ-Ⅱ级者22例。非颞叶癫癎22例,行致癎皮层切除术,15例达Engel Ⅰ-Ⅱ级。结论对于颞叶癫癎PET/CT检查能协助判断侧别。对于非颞叶癫癎,它可以帮助确定癫癎源的范围,指导颅内电极的植入。Objective To explore the role of PET/CT in presurgical evaluation of epilepsy. Methods 46 patients with refractory epilepsy underwent surgery were analysed in this study. All the cases got inter-ictal PET/CT examination presurgically, and followed up for 6-24 months postoperatively. Results Mesial temporal lobe epilepsy： Lateralized hypo-metablism tbei were found in all 24 cases. The results of PET/CT are highly accordant with that of scalp EEG,MRI and intracranial EEG recordings. All the 24 cases underwent the anterior temopral lobectomy, and 22 reached Engel I - 11.22 cases extra-temporal epilepsy negative in MRI,underwent the resection of epileptogenic foci, and 15 cases reached Engel l - I1 postoperatively. Conclusion PET/CT is significantly useful for lateralizing the epileptogenic source in mesial temporal lobe epilepsy. For extra-temporal epilepsy, the PET/CT might facilitate the determination of possible sites and extent of epileptogenic sources, and this could be the guidance for the implantation of intracranial electrodes.

关 键 词：PET/CT 癫(癎)外科 术前评估 

分 类 号：R742.1[医药卫生—神经病学与精神病学]