一体化^(18)F-FDG PET/MR联合ASL对难治性癫痫致痫区的定位诊断价值  

Diagnostic Values of Integrated^(18)F-FDG PET/MR Combined with ASL in Localization of Epilepsy Foci of Refractory Epilepsy

作　　者：刘义平 晏婷莉 高莎 郭佳 Liu Yiping;Yan Tingli;Gao Sha(Chengdu Dicom Medical Imaging Diagnostic Center,Chengdu,Sichuan 610072,China)

机构地区：[1]成都全景德康医学影像诊断中心,四川成都610072

出　　处：《四川医学》2025年第1期69-73,共5页Sichuan Medical Journal

摘　　要：目的研究一体化^(18)F-FDG PET/MR(以下简称PET/MR)联合动脉自旋标记(ASL)对难治性癫痫致痫区的定位诊断价值。方法回顾性搜集2021年12月至2023年12月我中心41例难治性癫痫患者的资料,41例患者均行PET/MR及ASL检查,视觉及半定量分析MR、ASL及PET图像,以手术结果及临床确定的致痫区为金标准,比较MR、ASL、PET/MR及PET/MR联合ASL这四种方法对致痫区定位的准确率,以及ASL与PET对皮层下结构脑功能异常的检出率。结果41例难治性癫痫患者中,MR、ASL、PET/MR及PET/MR联合ASL定位致痫区的准确率分别为58.54%(24/41)、75.61%(31/41)、80.49%(33/41)、82.93%(34/41)。PET/MR的定位准确率高于MR,差异有统计学意义(χ^(2)=4.661,P=0.031)。PET/MR联合ASL的定位准确率高于MR,差异具有统计学意义(χ^(2)=5.891,P=0.015)。PET/MR联合ASL的定位准确率略高于PET/MR,但差异无统计学意义(χ^(2)=0.082,P=0.775)。ASL与PET定位结果的一致性较高(Kappa=0.716,P<0.01)。结论一体化PET/MR联合ASL可明显提高MR对致痫区的定位准确率,对临床治疗具有重要的指导作用。Objective To investigate diagnostic values of integrated^(18)F-FDG PET/MR(PET/MR)combined with arterial spin labeling(ASL)in localization of epilepsy foci of refractory epilepsy.Methods A retrospective study was conducted on 41 patients with refractory epilepsy at our center from December 2021 to December 2023.All 41 patients underwent PET/MR and ASL examinations.MR,ASL,and PET images were visually and semi-quantitatively analyzed.Surgical results and clinically determined epileptogenic area were used as gold standard.Then,we compared the accuracy of MR,ASL,PET/MR,and PET/MR combined with ASL in locating the epilepsy foci and the detection rate of subcortical brain dysfunction by ASL and PET.Results The accuracy rates of MR,ASL,PET/MR and PET/MR combined with ASL in locating the epileptic area were 58.54%(24/41),75.61%(31/41),80.49%(33/41)and 82.93%(34/41)respectively.The localization accuracy of PET/MR was higher than MR with statistically significant difference(χ^(2)=4.661,P=0.031).The localization accuracy of PET/MR combined with ASL was higher than that of MR with statistically significant difference(χ^(2)=5.891,P=0.015).The localization accuracy of PET/MR combined with ASL was slightly higher than PET/MR without statistically significant difference(χ^(2)=0.082,P=0.775).The consistency between ASL and PET localization results was high(Kappa=0.716,P<0.01).Conclusion The combination of integrated PET/MR and ASL could significantly improve the accuracy of MR in locating the epileptic area,which has an important guiding role in clinical treatment.

关 键 词：难治性癫痫 正电子发射型断层扫描仪 磁共振成像 氟代脱氧葡萄糖 动脉自旋标记 

分 类 号：R817.4[医药卫生—影像医学与核医学]