异机融合^(18)F-FDG PET/MRI对癫痫灶的定位诊断价值  

Diagnostic Value of Registration Imaging ^(18)F-FDG PET/MRI in Localization of Epileptic Foci

作　　者：伍雪晴 李建东 路莉 赵海珊 韩翠平 徐凯 WU Xue-qing;LI Jian-dong;LU Li;ZHAO Hai-shan;HAN Cui-ping;XU Kai(Department of Radiology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院影像科,江苏徐州221000

出　　处：《中国CT和MRI杂志》2024年第7期7-10,共4页Chinese Journal of CT and MRI

摘　　要：目的研究了异机融合^(18)F-FDG PET/MRI在治疗癫痫方面的效果的定位诊断价值。方法回顾性分析2018年8月~2022年8月于徐州医科大学附属医院确诊为难治性癫痫的患者41例,患者均行正电子发射体层成像/计算机断层显像(^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography,^(18)F-FDG PET/CT)及磁共振成像(magnetic resonance imaging,MRI)检查,以立体定位脑电图(stereoelectroencephalography,SEEG)及术中皮层脑电图(electrocorticography,ECoG)作为诊断的金标准,探讨PET/MRI异机融合图像对于癫痫灶的定位诊断价值。41例患者均通过手术或颅内神经刺激器植入进行干预。结果41例患者中男性23例,女性18例。MRI显像阳性率65.9%(27/41),定侧准确率58.5%(24/41),定位准确率46.3%(19/41);^(18)F-FDG PET/CT阳性显像率95.1%(39/41),定侧准确率82.9%(34/41),定位准确率78.0%(32/41);^(18)F-FDG PET/MRI融合检查阳性率97.6%(40/41),定侧准确率95.1%(39/41),定位准确率90.2%(37/41)。41例患者中结节性硬化2例,海马硬化11例,局灶性皮质发育不良(FCD)7例,胚胎发育不良性神经上皮肿瘤(DNET)2例,海绵状血管瘤1例,均与MRI报告提示一致;余18例未发现明确病因。结论^(18)F-FDG PET/MRI对癫痫病灶检出及定侧、定位价值高于传统的MRI检查,而^(18)F-FDG PET/CT显像和^(18)F-FDG PET/MRI异机融合显像在难治性癫痫患者病灶检出阳性率和致痫灶定侧定位准确性上不存在显著差异。MRI对病因诊断更为明确。对于病因明确的患者及MRI阴性而^(18)F-FDG PET/CT显像阳性患者,其术后疗效好。Objective To explore the value of ^(18)F-FDG PET/MRI in the localization and diagnosis of epileptic foci.Methods A retrospective analysis of 41 patients diagnosed with refractory epilepsy in the Affiliated Hospital of Xuzhou Medical University from August 2018 to August 2022 was performed.All patients underwent positron emission tomography/computed tomography(^(18)F-FDG PET/CT)and magnetic resonance imaging(MRI).Stereo-electroencephalography(SEEG)and intraoperative electrocorticography(ECoG)were used as the gold standard for diagnosis to explore the diagnostic value of ^(18)F-FDGPET/MRI images for localization of epileptic foci.All 41 patients were intervened by surgery or intracranial nerve stimulator implantation.Results There were 23 males and 18 females in 41 patients.The positive rate of MRI imaging was 65.9%(27/41),the accuracy of lateralization was 58.5%(24/41),and the accuracy of localization was 46.3%(19/41).The positive imaging rate of ^(18)F-FDG PET/CT was 95.1%(39/41),the accuracy of lateralization was 82.9%(34/41),and the accuracy of localization was 78.0%(32/41).The positive rate of ^(18)F-FDG PET/MRI examination was 97.6%(40/41),the lateralization accuracy was 95.1%(39/41),and the localization accuracy was 90.2%(37/41).Among the 41 patients,there were 2 cases of nodular sclerosis,11 cases of hippocampal sclerosis,7 cases of focal cortical dysplasia(FCD),2 cases of dysembryoplastic neuroepithelial tumor(DNET)and 1 case of cavernous hemangioma,all of which were consistent with MRI reports.No definite cause was found in the remaining 18 cases.Conclusion The value of ^(18)F-FDG PET/MRI in the detection,localization and localization of epileptic foci was higher than that of traditional MRI examination,while there was no significant difference between ^(18)F-FDG PET/CT imaging and ^(18)F-FDG PET/MRI fusion imaging in the positive rate of lesion detection and the accuracy of localization and localization of epileptic foci in patients with refractory epilepsy.MRI is more clear in the diagnosis of etiology.

关 键 词：癫痫 磁共振成像 正电子发射计算机断层扫描 异机融合 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]