PET和EEG在顽固性癫痫诊断中的价值

目的探讨电视录像-动态脑电图监测(VEEG)和正电子发射断层扫描(PET)在癫痫灶定位诊断中的价值及两者之间的联系.方法 44例顽固性癫痫患者, 经VEEG及PET检查定位, 对两者的一致性进行了比较.在其中38例进行了癫痫外科手术治疗的患者中进一步记录了术中ECoG和术后病理,与上述两者进行比较.结果 PET阳性率为98%,EEG为95%;两者完全一致和部分一致率分别为50%和23%.在PET和EEG定位完全不一致的12例手术患者中,8例术中ECoG与PET相符,2例与EEG相符.结论 PET是诊断癫痫病灶灵敏有效的一种无创性检查,在EEG不能定位的患者中,能够提供有价值的补充信息.

FDG-positron emission tomography and EEG:The comparison in localizing in refractory epilepsy

ObjectiveTo study the values of EEG and 18F]2-deoxyglucose(FDG) positron emission tomography in localizing the epiletogenic cortex,and evaluate their relation.MethodsVideo-EEG(VEEG) and FDG-PET scans were performed in 44 patients with refractory epilepsy.Electrocorticography(ECoG) in surgery and patholopy were performed in 38 patients who had undergone neurosurgical therapy.Congruence among them were studied.Results43 patients(98%) had FDG-PET hypometabolism.42 patients(95%) had epileptiform wave.There were 22 patients(50%) whose PET and EEG were in complete congruence,whereas 10 patients(23%) in part congruence.12 patients who had undergone operation had controversial results in PET and EEG,8 cases had agreement between ECoG and PET,and 2 cases had agreement between ECoG and VEEG. ConclusionFDG-PET is a effective,sensitive and non-invasive investigation.It can provide valuable supplemental data in patients with unlocalized surface EEG.