氢质子磁共振波谱成像结合PET/MRI对癫痫的诊断价值分析

目的 氢质子磁共振波谱成像（hydrogen proton magnetic resonance spectroscopy imaging，1H-MRS）结合正电子发射断层扫描/计算机断层成像（positron emission tomography/computed tomography，PET/MRI）对癫痫的诊断价值分析。 方法 选取我院收治的癫痫患者74例为癫痫组，选取健康体检者50例为对照组。以立体定向脑电图（stereotactic EEG，SEEG）及手术病理方法为“金标准”，评估单一1H-MRS检查、PET/MRI融合成像、1H-MRS结合PET/MEI融合成像3种方式检出、病灶定位的诊断价值。 结果 相比患侧海马N-乙酰天门冬氨酸（N-acetyl-aspartate，NAA）/肌酸类（Creatine，Cr）、NAA/胆碱类化合物（Choline compounds，Cho）、NAA/（Cr+Cho）比值，健侧海马NAA/Cr、NAA/Cho、NAA/（Cr+Cho）比值较高（P＜0.05）；联合检查出率、阳性病灶定位符合率高于1H-MRS、PET/MRI融合检查（P＜0.05）。以SEEG及手术病理方法为“金标准”，1H-MRS、PET/MRI融合、联合检查敏感度分别为44.59%、55.41%、94.59%，特异度分别为54.05%、59.45%、78.29%，准确度分别为49.32%、57.43%、95.39%；AUC分别为0.764、0.788、0.812。其中联合检查特异度、AUC最高。 结论 通过1H-MRS结合PET/MRI对癫痫患者进行诊断，能够提高癫痫的准确度、具有良好诊断效能。

Diagnostic value of hydrogen proton magnetic resonance spectroscopy imaging combined with PET/MRI in epilepsy

Objective To investigate the diagnostic value of hydrogen proton magnetic resonance spectroscopy imaging (1H-MRS) combined with positron emission tomography/magnetic resonance imaging (PET/MRI) in epilepsy.Methods Seventy-four epilepsy patients admitted to our hospital were selected as the epilepsy group, while 50 healthy people undergoing physical examination during the same period were selected as the control group. Using stereotactic electroencephalography (SEEG) and surgical and pathological methods as the “gold standard”, the diagnostic value of the 3 modalities, including 1H-MRS examination alone, PET/MRI fusion imaging, 1H-MRS combined with PET/MRI fusion imaging, in detection and lesion localization was evaluated.Results Compared with the ratios of N-acetyl aspartate (NAA)/Creatine (Cr), NAA/choline compounds (Cho), NAA/(Cr+Cho) in the affected hippocampus, the ratios of NAA/Cr, NAA/Cho, NAA/(Cr+Cho) in the healthy hippocampus were higher (P＜0.05). The combined detection rate and the coincidence rate of positive lesion localization were higher than those of 1H-MRS and PET/MRI fusion imaging (P＜0.05). With SEEG and surgical and pathological methods as the “gold standard”, the sensitivity of 1H-MRS, PET/MRI fusion and combined detection of the two was 44.59%, 55.41% and 94.59% respectively, the specificity was 54.05%, 59.45% and 78.29% respectively, and the accuracy was 49.32%, 57.43% and 95.39% respectively. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.764, 0.788 and 0.812 respectively. The specificity and AUC of combined detection were the highest.Conclusion Diagnosis of epilepsy patients by 1H-MRS combined with PET/MRI can improve the accuracy of epilepsy with good diagnostic efficacy.