SPECT脑血流灌注药物诱发显像在原发难治性癫痫灶定位中的观察  

Localization of Epileptogenic Focus Using Medication-provoked Perfusion SPECT in Refractory Epilepsy

作　　者：王正江[1] 陈雪红[1] 柳江燕[1] 王晓慧[1] 鲁秀娟[1] 冯建中[1] 李继承[1] 刘娟[1] 

机构地区：[1]兰州大学第二医院核医学科,甘肃兰州730030

出　　处：《中国医学影像学杂志》2016年第10期729-731,734,共4页Chinese Journal of Medical Imaging

基　　金：兰州市自然科学研究基金(041284)

摘　　要：目的探讨难治性癫痫患者SPECT局部脑血流量(r CBF)显像在不同发作时段的影像特征及定位诊断的价值。资料与方法经临床确诊为原发难治性癫痫患者57例,分别进行发作间期、诱发试验(发作期)r CBF显像,并对29例患者再次进行诱发试验后(发作72 h内)r CBF显像,通过对难治性癫痫患者的不同发作时段的脑血流r CBF显像进行观察分析,研究致痫灶定位的临床应用价值。结果发作间期、诱发试验及诱发试验后SPECT显像的阳性率分别为70.1%(40/57)、91.2%(52/57)和93.1%(27/29)。诱发试验及诱发试验后显像阳性检出率高于发作间期显像,差异均有统计学意义(P<0.05)。诱发试验及诱发试验后SPECT检查结果相比,差异无统计学意义(P>0.05)。结论诱发试验及诱发试验后72 h内r CBF显像阳性检出率均可达90%以上,对癫痫灶定位有效率高于发作间期r CBF影像。诱发试验后72 h内延迟影像与诱发试验结果无显著差异,结合发作间期r CBF影像结果可作为癫痫灶定位较实用的诊断方法。Purpose To investigate the SPECT regional cerebral blood flow（r CBF） imaging characteristics in patients with refractory epilepsy during different seizure phases and to evaluate its value in localizing epileptogenic focus. Material and Methods Fiftyseven patients with clinically diagnosed refractory epilepsy underwent r CBF imaging during interictal and induced-ictal phases, as well as post-ictal（within 72 h） imaging in 29 patients. The cerebral blood flow in these patients was observed and analyzed to evaluate the clinical application in localizing epileptogenic focus. Results The SPECT imaging positive rates in interictal, induced-ictal and postictal phases were 70.1%（40/57）, 91.2%（52/57） and 93.1%（27/29）, respectively. The detection rates of ictal and postictal imaging were higher than interictal imaging with statistically significant difference（P0.05）, while the ictal and postictal imaging were not significantly different（P〉0.05）. Conclusion The ictal and postictal（〈72 h） r CBF imaging localization of epileptogenic focus is positive in more than 90% of the patients, more effective than interictal imaging. The postictal imaging is not significantly different than ictal imaging. Combining ictal and postictal r CBF imaging can be a feasible method in epilepsy localization.

关 键 词：癫痫 体层摄影术 发射型计算机 单光子 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R445.6[医药卫生—临床医学]