形态学分析方法在MRI结果阴性Ⅱ型局灶性皮质发育不良患者中的临床应用  

Clinical application of morphometric analysis program in patients with MRI-negative typeⅡfocal cortical dysplasia

作　　者：姚远 胡文瀚[2] 张弨[1] 王秀[1] 桑林[3] 郑重[3] 邵晓秋[4] 张凯[1] YAO Yuan;HU Wenhan;ZHANG Chao(Department of Neurosurgery,Beijing TianTan Hospital Affiliated to Capital Medical University,Beijing(100070),Beijing,China)

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100071 [2]首都医科大学北京市神经外科研究所,北京100071 [3]北京丰台医院神经外科 [4]首都医科大学附属北京天坛医院神经内科

出　　处：《癫痫与神经电生理学杂志》2023年第2期87-93,共7页Journal of Epileptology and Electroneurophysiology(China)

基　　金：国家重点研发计划资助(2021YFC2401201);首都卫生发展科研专项(首发2022-1-1071,首发2020-2-1076);国家自然科学基金(82071457,82271495,82201603,82201600)。

摘　　要：目的探索基于体素的形态学分析方法(MAP)在核磁共振结果阴性的Ⅱ型局灶性皮质发育不良(FCD)患者中的致痫区定位价值。方法回顾性分析北京天坛-丰台癫痫中心2019年1月至2020年12月期间54例病理诊断为FCDⅡ型的核磁共振阴性患者的病例资料。对患者的MRI图像进行MAP软件处理,比较MAP阳性和阴性患者的临床特点及预后情况。结果在本组54例患者中,MAP阳性与阴性患者在病程、手术年龄、病理情况及致痫灶位置等方面比较差异均无显著意义。在预后方面,MAP阳性患者的EngelⅠ级率达到81%,显著高于MAP阴性患者(P=0.032)。在行立体脑电图(SEEG)电极植入的46例患者中,MAP与SEEG结果一致的患者预后较好(P=0.049)。结论MAP技术能够用于辅助定位MRI阴性的Ⅱ型FCD患者的致痫区,指导SEEG电极植入,提高患者的手术预后。Objective To explore the value of a voxel-based morphometric analysis program(MAP)in localizing epileptogenic zones in patients with MRI-negative and typeⅡfocal cortical dysplasia(FCD).Methods The data of 54 patients with MRI-negative and typeⅡFCD confirmed by pathological diagnosis from January 2019 and December 2020 at the Beijing Tiantan-Fengtai Epilepsy Center was retrospectively analyzed.The patients'MRI images were processed with MAP software.The clinical characteristics and prognosis of the patients were compared between MAP positive and MAP negative patients.Results Among 54 patients,there were no significant differences in disease course,age at surgery,pathology,epileptogenic sites,etc.between MAP-positive and MAP-negative patients.In terms of prognosis,the EngelⅠrate was 81%in MAP-positive patients,which was significantly higher than that in MAP-negative patients(P=0.032).Among 46 patients who had stereoelectroencephalography(SEEG)electrode implantation,the prognosis was better in the patients with concordant MAP and SEEG results(P=0.049).Conclusion MAP can be used to assist in localizing the epileptogenic sites of MRI-negative typeⅡFCD,guiding SEEG electrode implantation,and improving the surgical prognosis of patients.

关 键 词：局灶性皮质发育不良 癫痫 形态学分析方法 基于体素的形态学 立体脑电图 

分 类 号：R741[医药卫生—神经病学与精神病学] R742.1[医药卫生—临床医学]