MRI与发作间期18F-FDG及UC-FMZ PET/CT显像对经典型海马硬化性难治性癫癎的诊断价值  

Clinical value of MRI,interictal 18F-FDG and 11 C-FMZ PET/CT imaging in the diagnosis of hippocampal sclerosing refractory epilepsy

作　　者：林都 王治国 张国旭 Lin Du;Wang Zhiguo;Zhang Guoxu(Postgraduate Training Base of Dalian Medical University,General Hospital of Northern Theater Command of PLAy Shenyang 110016,China;Department of Nuclear Mediciney General Hospital of Northern Theater Command of PLA,Shenyang 110016,China)

机构地区：[1]解放军北部战区总医院大连医科大学研究生培养基地,沈阳110016 [2]解放军北部战区总医院核医学科,沈阳110016

出　　处：《中华核医学与分子影像杂志》2019年第12期726-731,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的通过比较MRI、发作间期18F-脱氧葡萄糖(FDG)及nC-氟马西尼(FMZ)PET显像的定侧、定位准确性,探讨3种方法对经典型海马硬化(HS)难治性癫癎(REP)的诊断效能。方法回顾性分析2017年1月至2018年10月于解放军北部战区总医院行手术治疗、术后病理诊断为经典型HSREP的41例(男25例,女16例;年龄15〜61岁)患者。患者均在颞叶致癎灶切除术前行MRI、发作间期18F-FDG及nC-FMZPET/CT显像。以术后病理诊断为“金标准”。采用目测法及半定量法分析图像,采用妒检验比较3种方法对经典型HSREP的定侧、定位准确性。结果MRI对致癎灶的定侧、定位准确性分别为70.73%(29/41)和60.98%(25/41);发作间期18 F-FDG PET/C T显像的定侧、定位准确性分别为78.05%(32/41)和70.73%(29/41);发作间期11C-FMZ PET/C T显像的定侧、定位准确性均为100%(41/41),优于另2种方法(AT2值:1.976〜12.902,均/><0.01)。结论3种显像方法均有其优点及局限性,其中发作间期"C-FMZ PET/CT显像对经典型HSREP的定侧、定位有较高价值,有助于指导临床手术。Objective To compare the lateralization accuracy and localization accuracy of MRI,interictal 18F-fluorodeoxyglucose(FDG)and 11 C-flumazenil(FMZ)PET/CT imaging for refractory epilepsy(R E P)in patients with hippocampal sclerosis(H S).Methods A total of 41 classical HS patients(25 males,16 females;age:15-61 years)with REP from General Hospital of Northern Theater Command of PLA between January 2017 and October 2018 were retrospectively analyzed.All patients underwent MRI,interictal,8F-FDG and 11 C-FMZ PET/CT imaging,followed by the resection of epileptogenic foci.The pathological diagnosis was taken as the gold standard.Visual and semi-quantitative analyses were used to analyze the images.The lateralization accuracy and localization accuracy of the three imaging methods for epileptogenic foci were calculated and compared(A"2 test).Results The lateral accuracy and localization accuracy of MRI were 70.73%(29/41)and 60.98%(25/41),those of interictal l8F-FDG PET/CT imaging were 78.05%(32/41)and 70.73%(29/41),and those of interictal 11 C-FMZ PET/CT imaging were 100%(41/41)and 100%(41/41),respectively.The interictal 11 C-FMZ PET/CT imaging was the best among 3 imaging methods(/V2 values:1.976-12.902,all P<0.01).Conclusions All 3 imaging methods have their advantages and limitations.TTie interictal 11 C-FMZ PET/CT imaging has a high value in the localization of classical HSREP,which can significantly in^rove the diagnostic accuracy of classical HSREP and guide clinical operation.

关 键 词：癫痫 颞叶 硬化 海马 正电子发射断层显像术 体层摄影术 X线计算机 氟马西尼 碳放射性同位素 脱氧葡萄糖 磁共振成像 

分 类 号：R73[医药卫生—肿瘤]