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目的：探讨录像脑电图检测（Ｖｉｄｅｏ／ＥＥＧ），ＳＰＥＣＴ和ＭＲＩ３种方法对部分性癫痫的无创性定位和病因诊断的作用及临床意义。材料与方法：对５２例部分性癫痫患者分别进行Ｖｉｄｅｏ／ＥＥＧ，９９ｍＴｃＨＭＰＡＯＳＰＥＣＴ脑血流显像，１２３ＩＩｏｍａｚｅｎｉｌＳＰＥＣＴ脑受体显像和全脑ＭＲＩ检查。根据Ｖｉｄｅｏ／ＥＥＧ记录的癫痫发作类型，ＳＰＥＣＴ显示的ｒＣＢＦ和ＢＺＤ的分布以及ＭＲＩ显示的病灶及异常信号强度进行病灶定位、定性。结果：在５２例患者中，Ｖｉｄｅｏ／ＥＥＧ的定位敏感性为８８．５％（４６／５２）；１２３ＩＩｏｍａｚｅｎｉｌＳＰＥＣＴ的敏感性为５５．８％（２９／５２）；９９ｍＴｃＨＭＰＡＯＳＰＥＣＴ的敏感性为４８．１％（２５／５２）；ＭＲＩ的病灶检出率是５０．０％（２６／５２）。１２３ＩＩｏｍａｚｅｎｉｌＳＰＥＣＴ与ＭＲＩ联合检查，其病灶定位敏感性为８４．６％（４４／５２）。对１２例患者进行手术治疗，ＭＲＩ诊断的病理符合率为７５．０％（９／１２）。结论：１２３ＩＩｏｍａｚｅｎｉｌＳＰＥＣＴ与ＭＲＩ联合检查能提高部分性癫痫病灶定位的检出率，并能提供可能的病理诊断，具有临床实用价值。
Objective: To explore the effect and clinical significance of video / EEG, SPECT and MRI on the noninvasive localization and etiological diagnosis of partial epilepsy. Materials and Methods: 52 cases of partial epilepsy were video / EEG, 99mTc HMPAO SPECT cerebral perfusion imaging, 123I Iomazenil SPECT brain imaging and brain MRI examination. According to the type of epilepsy recorded by Video / EEG, the distribution of rCBF and BZD by SPECT and the lesions and abnormal signal intensity by MRI were used to locate and characterize the lesion. Results: The localization sensitivity of Video / EEG was 88.5% (46/52) in 52 patients. The sensitivity of 123IIomazenil SPECT was 55.8% (29/52). The sensitivity of 99mTcHMPAOSPECT The positive rate was 48.1% (25/52). The detection rate of MRI lesions was 50.0% (26/52). 123I IomazenilSPECT and MRI examination, the location of the sensitivity of the lesions was 84.6% (44/52). Surgical treatment was performed on 12 patients. The pathological coincidence rate of MRI diagnosis was 75.0% (9/12). Conclusion: 123I IomazenilSPECT combined with MRI can improve the detection rate of partial epilepsy location, and provide a possible pathological diagnosis, with clinical value.