MRI联合V-EEG在134例癫痫患者术前诊断中的价值分析

目的探讨磁共振成像(MRI)联合视频脑电图(V-EEG)应用于癫痫患者术前诊断的临床价值。方法回顾性分析134例癫痫患者临床资料,均经术中皮层脑电图(ECoG)监测确认致痫灶位置。比较术前MRI、V-EEG及二者联合定位致痫灶准确性差异,分析不同定位诊断情况预后效果(6个月时Engel分级)区别。结果 MRI联合V-EEG定位诊断致痫灶准确率明显高于单纯MRI或V-EEG,差异有统计学意义(P<0.05)。定位诊断获得准确诊断患者术后6个月时Engel分级明显低于漏诊/误诊患者,差异有统计学意义(P<0.05)。结论MRI联合V-EEG有助于提高癫痫患者术前致痫灶的定位诊断准确性。

Value of MRI Combined with V-EEG in the Preoperative Diagnosis of 134 Cases with Epilepsy

Objective To explore the clinical value of magnetic resonance imaging(MRI) combined with video electroencephalography(V-EEG) in the preoperative diagnosis of patients with epilepsy. Methods The clinical data of 134 patients with epilepsy were analyzed retrospectively. The location of epileptogenic foci was confirmed by intraoperative cortical electroencephalography(ECoG). The differences in the accuracy of preoperative MRI, V-EEG and the combination of the two were compared, and the prognosis effects(Engel classification at 6 months) of different localization diagnosis were analyzed. Results The accuracy rate of MRI combined with V-EEG in the localization diagnosis of epileptogenic foci was significantly higher than that of MRI or V-EEG alone, and the overall difference was statistically significant(P<0.05). The Engel classification in patients with accurate diagnosis in localization diagnosis was significantly lower than that in patients with missed diagnosis/misdiagnosis at 6 months after operation(P<0.05). Conclusion MRI combined with V-EEG helps to improve the accuracy of localization diagnosis of epileptogenic foci in patients with epilepsy before operation.