MRI与PET在颞叶癫癎中定位价值的比较

目的 比较ＭＲＩ及ＦＤＧ－ＰＥＴ在颞叶癫癎致癎灶定位中的价值，探讨癫癎外科术前定位的方法以及手术预后的判断。方法 以手术后癫癎控制状况为标准，对３０例颞叶癫癎患者的术前ＭＲＩ和ＦＤＧ－ＰＥＴ的结果进行比较，分析ＭＲＩ及ＰＥＴ各自在癫癎致癎灶定位中的价值。结果ＭＲＩ有良好的脑结构分辨能力，对于症状性癫癎的定位价值高，当ＭＲＩ显示海马硬化时，对致癎灶定位的意义大，术后癫癎发作完全控制的可能性大。发作间期ＰＥＴ对于颞叶癫癎定位的敏感性高于ＭＲＩ，但ＰＥＴ低代谢的范围往往超过致癎灶。与ＰＥＴ的目测方法比较，ＰＥＴ半定量分析并不能提高致癎灶定位的准确性及对手术效果的预测。结论　ＭＲＩ与ＰＥＴ检查结合可以提高致癎灶定位的准确性及对手术效果的预测，减少颅内记录的应用。

A comparison of the value of MRI and FDG-PET in the preoperative evaluation of temporal lobe epilepsy

Objective To evaluate the value of MRI and FDG-PET in the localization of epileptic foci in temporal lobe epilepsy and to discuss the relationship between pre-operative evaluation and outcome of surgery. Methods Pre-surgical examina- tions of MRI and FDG-PEr of 30 patients were analyzed. The value of MRI and FDG-PET in the pre-operative evaluation in tempo- ral lobe epilepsy were compared based on the post-operative results of seizure control. Results MRI was able to distinguish normal brain structural from leisions. Patients with hippocampal sclerosis in MRI demonstrated a good seizure control after surgery. The sensitivity of interictal PET was higher than MRI for the localization of temporal lobe epilepsy. Usually the area of hypometaholism in PET was larger than the epileptic foci. Compared with PET visual analysis, PET semi-quantitative analysis could not improve the accuracy of localization of epileptic foci. Conclusions Combination of PET and MRI improve the accuracy of localization of epilep- tic foci and reduce the need of intracranial recording.