发作间期癫痫灶的~(18)F-FDG PET/CT显像研究

目的 探讨~(18)F-FDG PET/CT对发作间期癫痫灶定性定位诊断价值.方法 病人空腹4-6 h以上,空腹血糖3.9～6.1 mmol/L,肘静脉注射显像剂~(18)F-FDG0.12 mCi/kg体质量,平静休息40 min后行脑部PET3D及CT断层显像,层厚3.75 mm,PET图像行衰减校正及迭代法重建多层面,多幅显示,连续两个层面以上肉眼可辨的放射性改变(低代谢、高代谢区)为癫痫灶.同时根据癫痫灶对放射性示踪剂的摄取进行半定量测定.对于多发癫痫灶采用痫灶部位及对侧同一部位SUVmax与小脑SUVmax相比.每个病人开颅后根据术前脑电、PET/CT结果行颅内电极(条状脑皮质电极、脑深部电极)监测癫痫灶的脑电情况,证实~(18)F-FDG PET/CT结果.结果 38例患者中37例检出癫痫灶,术中脑电证实癫痫灶部位较准确,1例颞叶癫痫未检出.单痫灶较多痫灶准确.结论 ~(18)F-FDG PET/CT是一种无创伤性、高度灵敏、较有效的癫痫灶定位方法.

Study of ~(18)F-SFDG PET/CT imaging in intericatal epileptogenic focus

Objective To explore the diagnostic value of ~(18)F-FDG PET/CT in qualitative and localizing analysis of epileptogenic foci during interictal period. Method Patient fasting 4-6 hours or more, fasting blood glucose 3.9～6. 1 mmol/L, elbow intravenous injection of imaging agent ~(18)F-FDG 0.12 mCi/kg,had 40 minutes calm rest, then did brain CT and PET3D tomography(slice thickness 3.75 mm). Dealing PET image with attenuation, proofing and iterative method to rebuild multi-section, multi-screen display. If naked eye could identify the radioactive changes(low metabolism,high metabolism areas) in more than two adjacent sections, the foci were confirmed. At the same time, according to data of radioactive tracer uptake of foci, semi-quantitative measurement was performed. For multiple epileptic foci, the comparison of SUVmax of focus and the same parts of contralateral site to the cerebellar SUVmax was performed. After craniotomy, acording to each patient's preoperative EEG, PET/CT results, the intracranial electrodes(cortical strip electrodes, deep brain electrodes) were set for monitoring the E EG of foci in order to prove ~(18)F-FDG PET/CT results. Results 37 foci were detected in 38 patients. The intraoperative EEG confirmed that the focus sites were accurate. One temporal lobe epilepsy case was not detected. Detection of single epileptogenic focus was more accurate than multiple epileptogenic foci. Conclusions ~(18)F-FDG PET/CT is a noninvasive, highly sensitive and effective method for epileptogenic focus positioning.