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目的 对脱氧葡萄糖 (18F DG)PET与MRI显像方法进行对比研究 ,观察PET与MRI在癫痫灶定位诊断中各自的优缺点。方法 32例经临床及脑电图诊断的颞叶癫痫患者分别在同期进行发作间期18F DGPET和MRI检查 ,用MRI的FLAIR序列扫描来显示海马结构 ,其中 2 6例定位明确的患者进行了颞叶切除手术 ,并进行术后的随访。图像分析通过目测的方法及图像信号强度测量的方法进行比较。 6例未行手术的患者中 ,3例因双侧病灶未行手术 ,1例为胶质瘤 ,另 2例失去随访。结果 2 6例进行颞叶切除的患者中 ,发现18F DGPET对癫痫灶检出率为 92 .30 % (2 4/2 6 ) ,而MRI对癫痫灶检出率为 80 .76 % (2 1/2 6 ) ,18F DGPET对癫痫灶的探测敏感性高于MRI,但MRI的图像定位精确程度则明显优于PET。结论 PET、MRI、皮层脑电图对癫痫病灶定位的一致性是手术成功的前提 ,仅从颞叶癫痫的定位诊断来看 ,PET比FLAIRMRI灵敏 ,但由于缺乏特异性 ,仅18F DGPET的低代谢并不能完全确定癫痫灶的位置 ,故需要其他的诊断措施加以肯定。而且18F DGPET和FLAIRMRI序列有互补的作用 ,两者的结合 ,可提高颞叶切除的成功率
Objective To compare the PET and MRI imaging methods of deoxyglucose (18F DG), and to observe the advantages and disadvantages of PET and MRI in the diagnosis of epileptic foci. Methods Twenty-two patients with temporal lobe epilepsy who were diagnosed by clinical and EEG methods were examined by 18F DGPET and MRI during the same period respectively. The hippocampal formation was revealed by MRI FLAIR sequence scan. Twenty-six patients with definite location were examined by temporal Leaf resection surgery, and postoperative follow-up. Image analysis is compared by means of visual inspection and image signal strength measurement. Of the 6 patients who did not undergo surgery, 3 had no surgery due to bilateral lesions, 1 had gliomas, and 2 had lost follow-up. Results Among the 26 patients with temporal lobe resection, the detection rate of 18F DGPET was 92.30% (2 4/2 6), while the detection rate of MRI on epileptic foci was 80.76% (2 1 / 2 6), 18F DGPET detective sensitivity of epileptic foci than MRI, but the accuracy of MRI image positioning was significantly better than PET. Conclusion PET, MRI and cortical EEG were the prerequisite for the successful operation of epilepsy. PET was more sensitive than FLAIRMRI only in the diagnosis of temporal lobe epilepsy. However, due to the lack of specificity, the low metabolism of 18F DGPET And can not completely determine the location of epileptic foci, it needs other diagnostic measures to be affirmed. And 18F DGPET and FLAIRMRI sequences have a complementary effect, the combination of the two can improve the success rate of temporal lobe resection