18F-FDGPET定位致痫灶在癫痫外科治疗中的价值

目的：评价^18F-脱氧葡萄糖（FDG）PET定位致痫灶在癫痫外科治疗中的作用。方法：对30例难治性癫痫患者行EEG，MRI，PET检查，根据PET检查结果并参考EEG，MRI选择外科治疗方法（开颅手术，X刀治疗，立体定向手术）。开颅手术者，术中行皮层脑电图（ECoG）检查，术后送病理检查。所有患者均观察术后疗效。结果：致痫灶位于颞叶22例，颞叶外6例，额颞区2例，30例患者中16例。30例患者中16例行开颅手术，10例X刀治疗，4例立体定向手术。术后除2例癫痫发作无明显改善外，余28例发作明显减少或消失。结论：^18F-FDG PET检查术前定位致痫灶有助于选择手术方式，提高手术治疗效果。

The role of interictal 18 F-FDG PET in epilepsy surgery

Objective To evaluate the value of the 18F-FDG PET localizing epileptic for surgical treatment. Methods 30 patients with medically intractable epilepsy received the examination of EEG, MRI, 18F-FDG PET, and underwent one of the three surgical therapies (open skull operation, X-knife, stereotactic operation) according to the results of examination. Results Twenty-two of the patients had temporal, 6 had extratemporal and 2 had frontal-temporal epileptic foci. According to the results of the noninvasive work-up, 16 patients were referred for open skull operation, 10 patients for X-knife and 4 patients for stereotactic operation. After treatment, for only 2 patients,the frequency of seizures remained as before, the remaining patients were all complete or almost seizure free. Conclusions In a considerable number of patients with medically intractable, particularly temporal epileptic foci, the selection of various surgical therapies can be based on the results of 18F-FDG PET examination. It can advance the curative effect on seizure episodes and avoid the risk of invasive work-up.