ECoG、EEG、fMRI及SEEG在MRI阴性癫痫患者外科手术中的应用  

Application of electrocorticogram,electroencephalogram,functional magnetic resonance imaging,and stereotactic electroencephalogram in surgical operation of epilepsy patients with negative magnetic resonance imaging findings

作　　者：裴祎楠 姜磊[1] 王西宪[1] 冯兆海[1] PEI Yi-Nan;JIANG Lei;WANG Xi-Xian;FENG Zhao-Hai(Department of Neurosurgery center of the First Affiliated Hospital of Xinjiang Medical University,Xingjiang,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院神经外科中心,新疆乌鲁木齐830054

出　　处：《国际神经病学神经外科学杂志》2021年第5期435-438,共4页Journal of International Neurology and Neurosurgery

基　　金：新疆维吾尔自治区自然科学基金(青年基金)(2017D01C344)。

摘　　要：目的探讨皮层脑电图(ECoG)、脑电图(EEG)、功能磁共振成像(fMRI)及立体定向脑电图(SEEG)在磁共振成像(MRI)阴性的癫痫患者外科手术的应用。方法选取2016年1月-2019年12月在新疆医科大学第一附属医院经MRI检查为阴性的癫痫患者246例,均对其行EEG、fMRI以定位致病灶。对致病灶定位明确者行手术切除治疗,另术中根据情况再次行ECoG或SEEG检查,术后再行fMRI、EEG检查。结果EEG检查致病灶明确率为79.27%(195/246),fMRI检查致病灶明确率为79.67%(196/246),两者致病灶明确率比较,差异无统计学意义(P>0.05);经EEG与fMRI检查均未见明显异常放电者有50例;ECoG与SEEG检查致病灶明确率分别为100.00%(26/26)和100.00%(24/24),两者检查致病灶明确率比较,差异无统计学意义(P>0.05)。结论EEG、fMRI、SEEG、ECoG检查在MRI阴性癫痫患者的致痫灶定位及手术切除指导中具有较好的应用价值,可精确定位并有效指引手术治疗。Objective To investigate the application of electrocorticogram(ECoG),electroencephalogram(EEG),functional magnetic resonance imaging(fMRI),and stereotactic electroencephalogram(SEEG)in surgical operation of epilepsy patients with negative magnetic resonance imaging(MRI)findings.Methods A total of 246 epilepsy patients who underwent MRI and had negative findings in our hospital from January 2016 to December 2019 were enrolled,and all patients underwent EEG and fMRI to localize the lesion.Surgical resection was performed for the patients with definite localization of the lesion;in addition,ECoG or SEEG was performed again according to the intraoperative situation,and fMRI and EEG were performed after surgery.Results The definite localization rate of lesions was 79.27%(195/246)for EEG and 79.67%(196/246)for fMRI,and there was no significant difference in the definite localization rate of lesions between EEG and fMRI(P>0.05).There were 50 cases without obvious abnormal discharge by EEG and fMRI examination.The definite localization rate of lesions was 100.00%(26/26)for ECoG and 100.00%(24/24)for SEEG,and there was no significant difference in the definite localization rate of lesions between ECoG and SEEG(P>0.05).Conclusions EEG,fMRI,SEEG,and ECoG have a good application value in the localization of epileptogenic focus and the guidance of surgical resection in epilepsy patients with negative MRI findings and can achieve accurate localization and effectively guide surgical treatment.

关 键 词：癫痫 皮层脑电图 脑电图 功能磁共振成像 立体定向脑电图 磁共振成像阴性 病灶定位 

分 类 号：R742.1[医药卫生—神经病学与精神病学]