正电子放射性药物对儿童皮质发育不良所致癫痫致痫灶的定位研究  

Effect of Positron Radiopharmaceuticals on Localization of Epileptogenic Foci of Epilepsy Caused by Focal Cortical Dysplasia in Children

作　　者：郭佳 高丹丹 张俊才 陈宇峰 GUO Jia;GAO Dan-dan;ZHANG Jun-cai;CHEN Yu-feng(General Hospital of Northern Theater Command,Shenyang 110016,China;Western Theater Command Center for Disease Control and Prevention,Lanzhou 730000,China)

机构地区：[1]北部战区总医院,辽宁沈阳110016 [2]西部战区疾病预防控制中心,甘肃兰州730000

出　　处：《解放军药学学报》2024年第6期515-519,522,共6页Pharmaceutical Journal of Chinese People's Liberation Army

基　　金：辽宁省自然科学基金,No.2021-MS-044;辽宁省医工交叉联合基金,No.2022-YGJC-06;沈阳市公共卫生研发专项,No.22-321-33-33。

摘　　要：目的评价正电子放射性药物对儿童局灶性皮质发育不良(FCD)所致癫痫的致痫灶进行定位分析的临床价值。方法回顾性分析34例FCD引发癫痫的儿童患者,均接受了^(11)C-氟马西尼(^(11)C-FMZ)和18F-氟代脱氧葡萄糖(18F-FDG)脑正电子发射断层显像磁共振成像(PET/MRI);以SEEG定位结果为标准,定性分析^(11)C-FMZ和18F-FDGPET低代谢范围及特征。结果34例FCD儿童患者中,共发现致痫灶44处,26例患者为单一致痫灶,5例表现为皮质多发病灶(其中3例病灶位于同一侧,2例病灶累及双侧皮质),3例为皮质与脑深部核团的混合性致痫灶。18F-FDG和^(11)C-FMZPET对致痫灶定侧诊断的准确度分别为85.29%(29/34)和82.35%(28/34),差异无统计学意义;在判断病变数目及位置的精准度方面,二者的准确度分别为65.90%(29/44)和86.36%(38/44),差异具有统计学意义(P<0.05)。结论正电子放射性药物^(11)C-FMZ可以在术前精准定侧、定位诊断FCD所致癫痫的致痫灶。Objective To evaluate the applicability of positron radiopharmaceuticals in localizing and analyzing epileptogenic foci of epilepsy caused by focal cortical dysplasia(FCD)in children with ^(11)C-Flumazenil(^(11)C-FMZ)and 18F-fluorodeoxyglucose(18F-FDG)PET/MRI.Methods The clinical data of 34 children with epilepsy caused by FCD was retrospectively analyzed,all of whom had received ^(11)C-FMZ and 18F-FDG brain PET/MRI before treatment.Using SEEG or intraoperative localization as diagnostic criteria,the hypometabolic range and characteristics of ^(11)C-FMZ and 18F-FDG PET were qualitatively analyzed before the efficacy of lateralization and localization was compared.Results Among the 34 children with FCD,44 epileptogenic foci were found Twenty-six of these cases were single and uniform epileptogenic foci,5 showed multiple lesions of the cortex(3 located on the same side,and 2 involving the bilateral cortex),and 3 were mixed epileptogenic foci of the cortex and deep brain nuclei.The accuracy of 18F-FDG and ^(11)C-FMZ PET in the diagnosis of fixed lateral epileptogenic foci was 85.29%(29/34)and 82.35%(28/34),respectively,without significant statistical difference.In terms of assessment of the number and location of lesions,the accuracy of the two was 65.90%(29/44)and 86.36%(38/44),respectively,and the difference was statistically significant(P<0.05).Conclusion The positron radiopharmaceutical-^(11)C-FMZcan accurately localize and diagnose the epileptogenic focus of FCD-induced epilepsy before surgery.

关 键 词：局灶性皮质发育不良 正电子发射断层显像 18F-氟代脱氧葡萄糖 ^(11)C-氟马西尼 

分 类 号：R969[医药卫生—药理学]