24小时动态脑电图和磁共振检查在癫痫诊断中的相关性  

The correlative relationship between AEEG and MRI in the diagnosis of epileptic patients

作　　者：王天俊[1] 郎森阳[1] 肖荣[1] 贾渭泉[1] 曹起龙[1] 蔡幼铨[2] 

机构地区：[1]解放军总医院神经内科,北京100853 [2]解放军总医院放射科,北京100853

出　　处：《中华神经科杂志》2001年第6期366-368,共3页Chinese Journal of Neurology

摘　　要：目的　观察 2 4h动态脑电图和头颅MRI在癫痫及其病因诊断中的相关性。方法　分析 6 0例癫痫患者的常规脑电图 (EEG)、2 4h动态EEG (AEEG)、头颅CT和MRI检查结果 ,应用卡方检验观察AEEG与MRI结果之间的相关性。结果　 6 0例中 19例 (32 %)患者常规EEG可见癫痫性放电 ;48例 (80 %)患者AEEG可见癫痫性放电 ;头颅CT检查 2 0例 (33%)患者发现病灶 ,MRI为 36例(6 0 %)。AEEG放电部位与MRI检出病灶的部位相符。以AEEG颞叶放电和颞叶外放电为两组进行比较 ,发现颞叶放电患者MRI的病灶部位与癫痫性放电部位符合率高。结论　AEEG发现癫痫性放电的异常率明显高于常规EEG ,MRI可显示与癫痫性放电病灶有关的结构特征 ,是癫痫病因诊断重要的定性手段。电生理检查发现的癫痫性放电部位与神经影像学检查显示的病灶 ,特别是颞叶病灶具有显著的相关性。Objective To analyse the role of AEEG and MRI in diagnosis of epilepsy on its primary epileptic focus and pathologic lesions. Methods We reviewed the results of sixty epileptic patients on routine EEG, twenty-four hour active EEG(AEEG),CT scanning and MRI examinations. The relationship between epileptic discharges of AEEG and lesions of MRI was analyzed by using χ 2 test. Results AEEG showed a higher sensitivity in finding epileptic focus in 80% patients, as compared with the rate of 32% in routine EEG. The sensitivity on finding the cerebral lesion related to the epileptic focus by using MRI was 60%, as compared with the rate of 33% in CT scanning. There was a correlative relationship between the AEEG discharge foci and the lesions found by MRI( P<0.05). MRI showed more primary lesions accordant with epileptic discharge in patients with temporal discharge than those with extratemporal discharge (P<0.05). Conclusions The ability of AEEG in finding epileptic discharge was higher than that of the routine EEG. MRI, as an important assistant method is to illustrate the pathologic character of lesions. There remain a correlative relation between electrophysiologic findings and neuroimaging results,especially in temporal lobe.

关 键 词：癫痫 脑图 磁共振成像 诊断 

分 类 号：R742.1[医药卫生—神经病学与精神病学]