发作间期PET和MR海马像在难治性颞叶癫癇术前定侧中的应用

目的 探讨发作间期18FDG-PET和MR海马像在难治性颞叶癫(?)（TLE）致(?)源术前定侧中的价值。方法 对17例药物难治性TLE患者术前定侧资料及术后随诊情况进行分析。结果 本组患者中,有12例（71％）患者MR显示海马硬化（HS）,海马萎缩与信号改变常共存,T2加权像和FLAIR序列有利于显示信号的改变。HS侧多提示为致(?)源侧。PET检查均显示有至少一侧颞叶低代谢改变,并常多发或范围弥散。PET与MR的定侧准确率分别是100％（13/13）、77％（10/13）,经x2检验两者间无差异（P>0.05）。结论　18FDG-PET和MR海马像在致(?)源定侧中的作用是互补的,当颞叶低代谢侧与海马硬化侧相一致时手术效果较好。

The contributions of interictal PET and MR in presurgical evaluation for intractable medial temporal lobe epilepsy.

Objective To assess the value of interictal 18FDG-PET and MR in presurgical evaluation for medically intractable temporal lobe epilepsy. Methods The data of presurgical evaluation and postsurgical follow-up from 17 patients with intractable temporal lobe epilepsy were retrospectively analyzed. Results In this selected patients group, MR images showed hip-pocampal sclerosis which were usually associated with epileptogenic region in 71% patients. Hippocampal atrophy usually coexist with a medical temporal signal intensity alteration in most patients, and the signal alteration were shown best on the T2-weighted image using the FLAIR sequence. PET revealed hypometabolism in at least one temporal lobe in all patients and hypometabolism was usually multifocal or diffuse. The lateralizetion accuracy of PET and MR for epileptogenic zone were 100%(13/13) and 77% (10/13) (P > 0.05). Conclusions The roles of interictal 18DFG-PET and MR in presurgical epileptogenic zone evaluation are complementary, and concordance of MR and interictal PET is usually associated with better surgical outcome.