小儿癫痫^18F—FDGPET／CT高代谢灶的判读及分析  

Analysis of hypermetabolic lesions on ^18F-FDG PET/CT scan in pediatric patients with epilepsy

作　　者：佟正灏 范岩[1] 王荣福[1] 蔡立新[2] 刘晓燕[2] 张建华[1] 张旭初[1] 付占立[1] 刘萌[1] Tong Zhenghao;Fan Yan;Wang Rongfu;Cai Lixin;Liu Xiaoyan;Zhang Jianhua;Zhang Xuchu;Fu Zhanli;Liu Meng(Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China;Pediatric Epilepsy Center, Peking University First Hospital, Beijing 100034, Chin)

机构地区：[1]北京大学第一医院核医学科,100034 [2]北京大学第一医院儿童癫痫中心,100034

出　　处：《中华核医学与分子影像杂志》2018年第4期234-237,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家重大科学仪器设备开发专项（2011YQ03011409）;“十二五”国家科技支撑计划（2014BAA03803）

摘　　要：目的探讨癫患儿^18F－脱氧葡萄糖（FDG） PET/CT脑显像高代谢灶的特点。方法回顾性研究2014年3月至2016年12月间^18F－FDG PET/CT脑显像表现为高代谢的23例癫患儿（男15例、女8例，年龄0.5～13.3岁）资料，采用目测法和半定量法分析图像；对其中14例手术患儿进行术后随访。结果^18F－FDG PET/CT脑显像示高代谢区多见于额叶和顶叶，可伴或不伴周围和（或）远处低代谢灶。检查当天8例无癫临床发作，14例有癫临床发作，1例不确定。行手术治疗的14例患儿中，9例手术取材部位与PET高代谢部位相符，病理结果分别为皮质发育畸形（8例）和Rasmussen脑炎（1例）；该9例患者随访示Engel分级Ⅰ级7例，Ⅲ级2例。结论癫患儿^18F－FDG PET/CT脑显像高代谢多见于额叶和顶叶，病理多为皮质发育不良。ObjectiveTo investigate the characteristics of metabolic foci on ^18F-fluorodeoxyglucose （FDG） PET/CT scan in pediatric patients with epilepsy.MethodsTwenty-three pediatric patients （15 males, 8 females, age range： 0.5-13.3 years） with epilepsy were retrospectively reviewed from March 2014 to December 2016. All patients underwent ^18F-FDG PET/CT and metabolic foci were found. The visual method and semi-quantitative analysis were used to analyze images. Fourteen of them underwent surgery and were followed up for 3-24 months.ResultsGlucose hypermetabolism were observed most frequently in the frontal and parietal lobes, with or without surrounding/remote hypometabolism. On the day of PET/CT imaging, 8 patients had no seizures, 14 patients had seizures, and 1 patient was uncertain. The sites of resection were consistent with the regions of hypermetabolism in 9 patients, among whom the pathological results showed 8 cortical malformations and 1 Rasmussen′s syndrome. Follow-up results for the above 9 patients showed that there was 7 Engel class Ⅰ patients and 2 Engel class Ⅲ patients.ConclusionThe hypermetabolism may mostly appear in the frontal and parietal lobes of pediatric patients with epilepsy, and malformations of cortical development seem to be the most common pathology results.

关 键 词：癫痫 儿童 正电子发射断层显像术 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R742.1[医药卫生—神经病学与精神病学]