SPECT定位指导治疗顽固性癫痫的疗效评估  

Curative effect assessment of the treatment of intractable epilepsy by SPECT positioning guide

作　　者：孙春雷[1] 辛明[1] 

机构地区：[1]山东省淄博万杰肿瘤医院核医学科,山东淄博255213

出　　处：《中国当代医药》2013年第25期109-110,114,共3页China Modern Medicine

摘　　要：目的探讨单光子发射型计算机断层扫描(SPECT)脑血流灌注显像在癫痫发作期和发作间期癫痫病灶定位中的应用价值。方法选取39例住院顽固性癫痫患者,在癫痫发作期和发作间期行脑部SPECT定位致痫灶,并与发作间期正电子发射计算机断层扫描(PET)、MRI、脑电图(EEG)比较检查结果符合率;根据SPECT定位行开颅致痫灶切除手术治疗或定位放射治疗;随访患者接受手术或放疗后2～3年癫痫发作次数及发作程度,采用ILAE分级法进行临床疗效评估分级。结果 39例顽固性癫痫患者脑致痫灶SPECT与PET、MRI、EEG检查结果符合率分别为15.4%、5.1%、0.0%;治疗前后每日平均发作频次比较差异有统计学意义(P<0.05)。结论应用SPECT脑血流灌注显像在癫痫发作期和发作间期对顽固性癫痫病灶进行定位指导治疗效果较好,具有较高的临床应用价值。Objective To investigate the application value of single photon emission computed tomography（SPECT） cerebral blood flow perfusion imaging in epileptic foci localization during epilepsy ictal and interictal. Methods The epileptogenic foci of 39 hospitalized patients with intractable epilepsy were location by cerebral SPECT in epilepsy ictal and interictal.The results were compared with positron emission tomography （PET）,MRI and electroencephalogram （EEG） to check the coincidence rate in interictal.Craniotomy and epileptogenic foci resection operation or radiation therapies were been done according to the SPECT localization.Follow-up of patients received operation or radiotherapy after 2-3 years during epileptic seizure frequency and the attack degree,the ILAE classification was adopted for clini- cal efficacy assessment classification. Results The consistent rate of brain epileptogenic foci SPECT between PET,MRI and EEG findings to 39 patients with intractable epilepsy was 15.4%,5.1% and 0.0% respectively.Compared with before and after the treatment,the difference of daily average onset frequency was statistically significant （P〈0.05）. Conclusion The application of the SPECT brain perfusion imaging in epilepsy ictal and interictal in intractable epileptic foci localization guide treatment curative effect is very well,and with clinical application value.

关 键 词：顽固性癫痫 单光子发射型计算机断层扫描 定位指导 疗效评估 

分 类 号：R742.1[医药卫生—神经病学与精神病学]