尚建文,马云川,李德鹏,苏玉盛,张琳瑛,彭程,张建国,孙振荣.18F-FDG PET脑显像对癫痫颅内电极放置部位的选择[J].中国医学影像技术,2007,23(5):774~776
18F-FDG PET脑显像对癫痫颅内电极放置部位的选择
Value of 18F-FDG PET in directing intracranial electrode placement to sites of epileptogenic focus
投稿时间:2007-01-12  修订日期:2007-03-26
DOI:
中文关键词:  正电子发射断层  氟代脱氧葡萄糖  癫痫  颅内电极  皮层脑电图
英文关键词:Positron emission tomography  Deoxyglucose  Epilepsy  Intracranial electrode  Electrocorticography
基金项目:
作者单位E-mail
尚建文 首都医科大学宣武医院PET中心,北京 100053 shangjianwen@sina.com.cn 
马云川 首都医科大学宣武医院PET中心,北京 100053  
李德鹏 首都医科大学宣武医院PET中心,北京 100053  
苏玉盛 首都医科大学宣武医院PET中心,北京 100053  
张琳瑛 首都医科大学宣武医院PET中心,北京 100053  
彭程 首都医科大学宣武医院PET中心,北京 100053  
张建国 首都医科大学天坛医院脑外科,北京 100053  
孙振荣 首都医科大学天坛医院脑外科,北京 100053  
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中文摘要:
      目的 探讨18F-FDG PET脑显像对癫痫颅内电极放置位置选择的价值。方法 52例难治性癫痫患者,其中男28例,女24例,年龄在7~38岁之间,平均22岁。所有患者脑MRI检查结果无异常。头皮EEG检查阴性23例,头皮EEG检查不确定癫痫部位的29例。采用SIEMENS ECAT47 PET扫描仪行18F-FDG PET脑断层显像,在PET指导下经颅内电极定位后行癫痫灶切除。结果 52例癫痫18F-FDG PET 显像阳性患者中,发作期8例呈18F-FDG摄取增高,发作间期44例呈18F-FDG摄取减低。发作期18F-FDG PET显像所提示的18F-FDG摄取增高部位,颅内电极都可检测到癫痫波。18F-FDG摄取减低44例患者,能记录癫痫波者39例,有效率为88.6%。5例不能检测癫痫波,无效率为11.4%。结论 18F-FDG PET显像对癫痫颅内电极放置位置选择具有指导的价值,尤以发作期18F-FDG PET显像明显。
英文摘要:
      Objective To explore possibility of 18F-FDG PET imaging in directing intracranial electrode placement to sites of epileptogenic focus. Methods Fifty-two cases with intractable epilepsy were studied in 18F-FDG PET, all of them presented with normal MRI.Out of 52, 23 cases were negative and seizure focus in 29 could not be located in scalp electroencephalography (S-EEG). 18F-FDG PET cerebral imaging was done using SEIMENS ECAT47 scanner before operation. Intracranial electrode placement to sites of epileptogenic focus was chosen according to the results from 18F-FDG PET imaging,diagnostic accuracy in 18F-FDG PET imaging was determined according to the results from electrocorticography (ECoG) or intracranial electroencephalography (I-EEG). Results Epileptogenic foci presented with hypermetabolism in 8 cases during ictal state, hypometabolism in 44 interictally in 18F-FDG PET imaging.According to above results, epileptogenic focus could be found in 8 cases with ictal epilepsy and in 39 cases with interictal epilepsy by EcoG or I-EEG. However, epileptogenic focus could not be located in other 5 cases with interictal epilepsy. Diagnostic accuracy during ictal and interictal was 100%, 88.6%,respectively. Conclusion 18F-FDG PET imaging can be used to localize epileptogenic focus and direct intracranial electrode placement for recording ictal onsets according to metabolic change in sites of epileptogenic foci,especially ictally.
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