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目的:评价18F-FDG PET/CT显像在颞叶癫癎术前的定位作用。方法:对53例临床诊断为颞叶癫癎患者行EEG检查及Discovery LS PET/CT扫描仪显像,其中的38例在皮质脑电图(ECoG)监测下行手术治疗,比较EEG、术中ECoG及病理结果与18F-FDG PET/CT显像定位的一致性。结果:53例患者均获得清晰的脑解剖与功能双重显像;颞叶癫的PET/CT显像敏感性为94.3%(50/53);PET结果阳性的50例中,多种EEG检查发现有明确癫癎样放电者为42例(85.0%),其中明确有定侧意义32例与PET/CT结果完全或基本一致的占93.8%(30/32),定侧结果相反2例。38例接受手术者,PET/CT结果与术中ECoG定位完全或基本相符的32例,相反6例,所有患者病理结果均证实为海马硬化或萎缩;以ECoG监测结果为标准,PET/CT对癫灶检出的特异性为84.2%(32/38)。结论:18F-FDG PET/CT可以实现颞叶癫癎的解剖与功能双重显像,是颞叶癫癎灶术前定位较为灵敏有效的一种无创检查,但其显像结果的解释必须慎重,尤其应强调PET/CT结果与EEG结果的一致性是病灶定侧定位的关键。
Objective: To evaluate the localization of 18F-FDG PET / CT before temporal lobe epilepsy. Methods: Fifty-three patients with temporal lobe epilepsy were examined by EEG and Discovery LS PET / CT. 38 of them were surgically treated with ECoG monitoring. EEG, intraoperative ECoG The pathological results were consistent with those of 18F-FDG PET / CT imaging. Results: All the 53 patients had clear brain anatomy and functional double imaging. The temporal and epileptogenic PET / CT imaging sensitivities were 94.3% (50/53). Among the 50 PET positive cases, multiple EEG findings There were 42 cases (85.0%) with definite epileptiform discharges, of which, there were definite definite side effects of 32 cases (93.8%, 30/32) completely or basically consistent with PET / CT findings and 2 cases of contralateral side effects. Thirty-eight patients underwent surgery, and PET / CT findings were completely or basically consistent with intraoperative ECoG location in 32 patients and 6 patients on the contrary. All the patients were confirmed with hippocampal sclerosis or atrophy as pathological findings. According to ECoG monitoring results, PET / CT The specificity of detection of epilepsy was 84.2% (32/38). Conclusion: 18F-FDG PET / CT can achieve the dual imaging of temporal lobe epilepsy, which is a sensitive and effective method for the preoperative localization of temporal lobe epilepsy. However, the interpretation of its imaging results must be interpreted with caution. In particular, it should be emphasized that the consistency of the results of PET / CT and EEG is the key to localization of the lesion.