形态学分析测定程序在儿童局灶性皮质发育不良Ⅱ型病灶影像检出中的应用价值研究  

Morphometric analysis program in detecting focus of pediatric epilepsy related to focal cortical dysplasia II

作　　者：邢亚洲[1] 赵婷[2] 赖生龙 范宏业[3] Xing Yazhou;Zhao Ting;Lai Shenglong;Fan Hongye(Department of Neurosurgery,He'nan Provincial People's Hospital,Zhengzhou 450003,China;Department of Neurology,He'nan Provincial People's Hospital,Zhengzhou 450003,China;Department of Pediatrics,He'nan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院神经外科,郑州450003 [2]河南省人民医院神经内科,郑州450003 [3]河南省人民医院儿科,郑州450003

出　　处：《中华神经医学杂志》2024年第6期603-606,共4页Chinese Journal of Neuromedicine

基　　金：河南省科技厅科技攻关项目(242102311276)。

摘　　要：目的探讨形态学分析测定程序(MAP)在提高儿童局灶性皮质发育不良(FCD)Ⅱ型病灶影像检出率中的应用价值。方法回顾性选择河南省人民医院神经外科自2020年6月至2023年1月收治的42例术后EngelⅠ级的FCDⅡ型癫痫患儿为研究对象,应用MAP对患儿术前MRI数据进行分析,比较MAP阳性组与阴性组间一般资料的差异、MRI和MAP中病灶检出率的差异以及MAP真阳性和假阳性(依据术后CT资料判读)与发作间期PET低代谢阳性一致率的差异。结果本组42例患儿中,致痫区MAP阳性28例,阴性14例。MAP阳性组与阴性组患儿在性别方面的差异有统计学意义(P<0.05),MAP中病灶检出率(28/42)与MRI中病灶检出率(19/42)的差异有统计学意义(P<0.05),MAP真阳性与发作间期PET低代谢阳性一致率(40/43)和MAP假阳性与发作间期PET低代谢阳性一致率(4/33)的差异有统计学意义(P<0.05)。结论MAP可有效提高儿童FCDⅡ型病灶的影像检出率,PET有助于MAP假阳性的判断。Objective To explore the value of morphometric analysis program(MAP)in detecting focus of pediatric epilepsy related to focal cortical dysplasia(FCD)II.Methods A retrospective analysis was performed;42 epilepsy children with FCD II and postoperative Engel grading I in Department of Neurosurgery,He'nan Provincial People's Hospital from June 2020 to January 2023 were enrolled.Preoperative MRI data were analyzed by MAP.Difference in general data and focus detection rate by MRI and MAP were compared between the positive MAP group and negative MAP group,and consistency of MAP positive areas(true positive MAP and false positive MAP by postoperative CT)with interictal PET low metabolism positive areas was analyzed.Results Of the 42 children,28 had positive MAP and 14 had negative MAP in the epileptogenic focus.Gender was statistically different between positive MAP group and negative MAP group(P<0.05).MAP had significantly better performance in focus detection compared with MRI(28/42 vs.19/42,P<0.05).Significant difference was noted between consistency of true positive MAP area with interictal PET low metabolism positive areas(40/43)and that of false positive MAP area with interictal PET low metabolism positive areas(4/33,P<0.05).Conclusion MAP can improve the focus detection rate of pediatric epilepsy related to FCD II effectively,and PET contributes to rule out false positive results.

关 键 词：癫痫 局灶性皮质发育不良 形态学分析测定程序 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]