动脉自旋标记成像用于平扫MR阴性发作间期癫痫患儿

目的 观察动脉自旋标记（ASL）成像对平扫MR阴性的发作间期癫痫患儿的诊断价值。方法 纳入56例平扫MR未显示结构异常的发作间期癫痫患儿，采用视觉分析法将ASL显示灌注异常分为低灌注或高灌注，与临床及视频脑电图（VEEG）定位癫痫灶结果进行一致性检验，并分析ASL异常灌注的影响因素。结果 56例中，52例（52/56，92.86%）为癫痫局灶性发作，4例（4/56，7.14%）为全身性发作。39例（39/56，69.64%）ASL显示灌注异常，37例（37/52，71.15%）为局灶性发作、2例（2/4，50.00%）为全身性发作；其中20例（20/39，51.28%）ASL显示灌注异常定位与临床定位癫痫灶完全一致，9例（9/39，23.08%）部分一致；ASL定位癫痫灶与临床定位结果具有中等一致性（Kappa=0.46，P<0.01）。于发作1天内行ASL是唯一与MR和临床定位癫痫灶一致性相关的因素（P<0.05）OR=3.81，95% CI（1.16，12.44），P=0.027]。结论 ASL技术可于发作间期有效定位平扫MR阴性癫痫患儿的癫痫灶。

Arterial spin labeling imaging in interictal epilepsy children with negative plain MR results

Objective To observe the value of arterial spin labeling (ASL) in children with interictal epilepsy with negative plain MR results. Methods A total of 56 interictal epileptic children with negative plain MR results were included. ASL abnormalities were classified into hypo/hyperperfusion based on visual assessment and compared with the seizure focus determined by clinical data and video-electroencephalography (VEEG). The impact factors of abnormal ASL perfusion were analyzed. Results Among 56 cases, 52 (52/56, 92.86%) had focal seizures and 4 (4/56, 7.14%) had generalized seizures. Abnormal perfusion changes were found in 39 cases (39/56, 69.64%),including 37 cases (37/52, 71.15%) of focal seizures and 2 cases (2/4, 50.00%) of generalized seizures, among them 20 (20/39, 51.28%) ASL findings were completely consistent and 9 (9/39, 23.08%) were partially consistent with clinical localization of epileptic foci. ASL localization of epileptic foci was moderately consistent with clinical localization (Kappa=0.46, P<0.01). ASL acquired within 1 day after seizure was the only factor significantly associated with the consistency of ASL and clinical localization of epileptic foci (OR=3.81, 95% CI1.16, 12.44], P=0.027). Conclusion ASL technique could effectively locate interictal epileptic foci in children with negative plain MR results.