脑磁图在耐药性癫(癎)术前定位中的价值及影响因素探讨

目的:评价脑磁图(MEG)在耐药性癫癎术前定位中的价值并探讨影响其定位的因素。方法:在47例术前均行MEG,VEEG,MRI检查的耐药性癫癎病例中,以术中皮层脑电图(ECoG)为金标准,比较VEEG和MEG定位准确性,并作影响MEG和VEEG定位的logistic多因素分析。结果:47例颞叶癫癎中,MEG与ECoG完全吻合32例(68％),部分吻合8例(17％);VEEG与ECoG完全吻合18例(38％),部分吻合23例(49％)。MEG与ECoG完全吻合病例明显多于MEG与VEEG吻合例(P <0．05)。MEG定位的多因素分析显示发作频率对MEG定位有影响(P<0．05)。结论:MEG的应用有助于致癎灶的准确定位和手术方式的选择,在难治性颞叶癫癎的术前定位中有重要的临床应用价值。

Clinical value and influencing factors of magnetoencephalogrphy localizing epileptogenic lesion before surgery in patients with intractable epilepsy

Objective:To explore the clinical value of MEG for epileptic lesion localization before surgery in patients with intractable epilepsy. Methods: MEG, Video-EEG and MRI were performed in 47 cases with intractable epilepsy before surgery. ECoG in surgery was taken as the "golden standard", comparing the rate of coincidence with ECoG between MEG and VEEG. The factors that influence the localization of MEG were determined through Logistic analysis. Results: In all cases,MEG was coincident to ECoG wholly in 32 cases (68%) and 8 cases (17%) partly coincident; VEEG was coincident with ECoG wholly in 18 cases (38%) and 23 cases (49%) partly coincident) MEG localization was more accurate than VEEG (P<0. 05). The seizure frequency did influence MEG localization in logistic analysis (P <0. 05). Conclusions: MEG is helpful for detecting epileptogenic lesion before surgery and the choice of surgical method. It shows important clinical value in pre-surgery evaluation of patients with intractable epilepsy.