局灶性难治性颞叶癫痫全脑葡萄糖代谢特点

目的 探讨局灶性难治性颞叶癫痫全脑葡萄糖代谢特点。方法 回顾性分析2017年1~12月行发作间期18FDG-PET/CT检查的23例局灶性难治性颞叶癫痫的影像学资料。将PET图像导入MIM neuro软件，软件自动分析癫痫病人葡萄糖代谢水平与正常人群葡萄糖代谢的差异，各脑区差异结果以Z-Score值显示，分析颞叶癫痫病人全脑葡萄糖代谢特点。结果 术后病理为脑皮质发育不良22例，节细胞胶质瘤1例；病灶位于左侧颞叶16例，右侧颞叶7例。除颞叶呈葡萄糖低代谢改变外，还存在同侧海马、海马旁回、岛叶、杏仁核、颞叶岛盖以及双侧小脑半球葡萄糖代谢不同程度减低；对侧颞叶、额叶、顶叶、顶上小叶以及角回葡萄糖代谢不同程度增高。结论 颞叶癫痫具有一定葡萄糖代谢特点，其特定的葡萄糖代谢特点有助于更加精准的癫痫术前定位及其病理特征的分析。

Characteristics of global glucose metabolism in patients with focal intractable temporal lobe epilepsy

Objective To explore the characteristics of global glucose metabolism in the patients with focal intractable temporal lobe epilepsy. Methods Of 23 patients with focal refractory temporal lobe epilepsy [male, 11 and female, 12; aged (25.6±10.1) years] received interictal β-2-Fluorine-18-Fluro-2-deoxy glucose (18F-FDG) positron emission tomography (PET)/CT examination from January to December, 2017, 22 suffered from cerebral cortical dysplasia and 1 from ganglioglioma proved by postoperative pathological examination. The foci were in the left temporal lobes of 16 patients and they were in the right temporal lobes of 7 patients. The PET images were led into MIM neuro software, by which the differences in the glucose metabolism between patients with epilepsy and normal subjects were automatically analyzed. The above-mentioned results of different brain regions were shown by Z-Score value. Results The images of 18F-FDG PET showed that in the patients with temporal lobe epilepsy, there was different glucose hypometabolism in the ipsilateral hippocampus, parahippocampal gyrus, insula, amygdala, temporal operculum and bilateral cerebellar hemisphere, and glucose hypermetabolism in the contralateral temporal lobe, frontal lobe, parietal lobe, parietal lobule and angular gyrus besides the glucose hypometabolism in the temporal lobe. Conclusion The characteristics of glucose metabolism may be helpful to localization of seizure foci and to understanding of epileptic etiopathogenesis in the patients with temporal lobe epilepsy.