癫痫不同时期脑血流灌注显像动态观察在致痫灶定位诊断中的应用  

Dynamic Observation of Multiphases Cerebral Blood Flow Perfusion Imaging in Localization of Epileptogenic Foci

作　　者：郝科技 王茜[1] 李原[1] 邱李恒 HAO Keji;WANG Qian;LI Yuan;QIU Liheng(Department of Nuclear Medicine,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院核医学科,北京100044

出　　处：《中国医学影像学杂志》2021年第2期126-130,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨癫痫发作不同时期脑血流灌注显像的动态观察对致痫灶定位的价值。资料与方法回顾性分析20例行2次及以上脑血流灌注显像癫痫患者的临床资料,观察癫痫发作不同时期致痫灶区脑血流灌注变化情况;对照术后病理及临床随访结果分析多时相显像对致痫灶的定位效能。结果本组患者中,发作期、发作后及发作间期显像分别占34.1%、20.5%和45.4%。16例行2次显像的患者中:11例致痫灶的局部血流灌注表现为发作期或发作后增高或正常,发作间期减低;4例表现为发作间期无异常,发作期或发作后增高;1例表现为发作期和发作间期均减低,但患侧基底节增高。4例行3次显像者均显示出血流灌注变化脑区。对照术后病理及临床随访结果,采用癫痫不同时期显像动态观察的方法对致痫灶的定位准确性达91.7%(11/12)。结论癫痫不同时期脑血流灌注显像的动态观察对定位致痫灶具有较高的临床价值。Purpose To explore the value of dynamic observation of cerebral blood flow perfusion imaging in different stages of epileptic seizure in locating epileptogenic foci.Materials and Methods Twenty patients with epilepsy who underwent twice or more cerebral perfusion imaging were analyzed retrospectively.Changes of cerebral blood perfusion in epileptogenic foci in different stages of the seizure were observed,and the efficiency of the multi-stage imaging for localization of epileptogenic foci was evaluated based on the postoperative pathology and clinical follow-up.Results Ictal,postictal or interictal imaging was obtained in 34.1%,20.5%and 45.4%of the patients,respectively.For 16 patients underwent twice imaging,the blood perfusion in epileptogenic foci was elevated or normal on ictal or postictal imaging and decreased in the interictal imaging in 11 patients;normal on interictal imaging and elevated on ictal or postictal imaging in 4 patients;decreased on interictal or ictal imaging in one patient.The other 4 patients who underwent three times imaging all showed blood perfusion changes of cerebral region.The accuracy of locating epileptogenic foci by dynamic observation of mutiplephases imaging was 91.7%(11/12).Conclusion Dynamic observation of mutiplephases cerebral blood flow perfusion imaging has a higher accuracy in preoperative locating epileptogenic foci.

关 键 词：癫痫 发作后 体层摄影术 发射型计算机 单光子 放射性核素显像 诊断 

分 类 号：R445.5[医药卫生—影像医学与核医学] R742.1[医药卫生—诊断学]