对比视频脑电图与MRI在颞叶癫痫定位诊断中的应用价值  

Comparison of the value of video EEG and MRI in the diagnosis of temporal lobe epilepsy

作　　者：朱慧 ZHU Hui(Center of Electroencephalography,Wutai Mountain Hospital,Yangzhou,Jiangsu 225000,China)

机构地区：[1]江苏省扬州五台山医院脑电中心,江苏扬州225000

出　　处：《影像研究与医学应用》2022年第16期16-18,共3页Journal of Imaging Research and Medical Applications

摘　　要：目的:对比视频脑电图(video-electroencephalography,VEEG)与MRI在颞叶癫痫(temporal lobe epilepsy,TLE)定位诊断中的应用价值。方法:选取2019年6月—2021年6月江苏省扬州五台山医院收治的80例TLE患者临床资料,所有患者均拟行经典药物规范化治疗,治疗前均接受头颅MRI以及VEEG检查,对比二者在TLE治疗前定位诊断中的应用价值及VEEG特征性表现。结果:80例患者发作间期VEEG检查中,14例患者存在双侧半球独立痫样放电,57例患者局限于一侧半球的痫样放电,9例患者在发作间期VEEG中未见典型痫样放电;80例患者共采集到发作期VEEG记录共21例、62次发作记录,21例患者中明确内侧颞叶癫痫(MTLE)15例,外侧颞叶癫痫(LTLE)6例。80例患者MRI检查结果中存在25例患者海马和(或)杏仁核硬化,21例患者为单纯海马或杏仁核硬化,另有45例患者未见明显结构性病变,多表现为颞叶软化灶、脑萎缩、角质增生,15例患者MRI检查结果无异常。MRI定位诊断结果与VEEG结果比较无显著差异(P <0.05),并且MTLE与LTLE患者背景活动异常分布情况比较存在显著差异(P <0.05)。结论:VEEG作为一种简单、易行的检查方案,可用于颞叶癫痫的定位诊断,且诊断准确率较高,并可根据不同时期VEEG表现进行治疗预后的预测,尽可能避免或减少侵入性检查,具有应用及推广价值。Objective To compare the value of video electroencephalography(VEEG)and MRI in the diagnosis of temporal lobe epilepsy(TLE).Methods The clinical data of 80 TLE patients admitted to Jiangsu Yangzhou Wutaishan hospital from June 2019 to June 2021 were retrospectively analyzed.All patients planned to receive canonical treatment with classical drugs,and received head MRI and VEEG examination before treatment.The application value of the two in the location diagnosis before TLE treatment and the characteristic manifestations of VEEG were compared.Results During the VEEG examination of 80 patients,14 patients had independent epileptic discharge in both hemispheres,57 patients had epileptic discharge confined to one hemisphere,and 9 patients had no typical epileptic discharge in the VEEG of interictal patients.A total of 21 cases and 62 seizure records were collected from 80 patients.Among the 21 patients,15 cases of medial temporal lobe epilepsy(MTLE)and 6 cases of lateral temporal lobe epilepsy(LTLE)were identified.Among the 80 patients,there were 25 cases of hippocampal and/or amygdala sclerosis,21 cases of simple hippocampal or amygdala sclerosis,45 cases of no obvious structural lesions,mainly manifested as temporal lobe malacia,brain atrophy,keratoplasia,and 15 cases of no abnormal MRI results.There was no significant difference between MRI location diagnosis results and VEEG results(P<0.05),and there was significant difference in the distribution of background activity abnormalities between MTLE and LTLE patients(P<0.05).Conclusion VEEG,as a simple and feasible examination scheme,can be used for the location diagnosis of temporal lobe epilepsy with high diagnostic accuracy,and can be used to predict the treatment prognosis according to the manifestations of VEEG in different periods,so as to avoid or reduce invasive examination as much as possible,which has application and promotion value.

关 键 词：视频脑电图 MRI 颞叶癫痫 致痫灶定位 定位诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]