[1]王国福　杨　明　栾国明　钟旭光　林耀新.PET-MRI影像融合技术在颞叶癫痫手术中的应用[J].中国临床神经外科杂志,2017,(06):372-375.[doi:10.13798/j.issn.1009-153X.2017.06.002]
　WANG Guo-fu,YANG Ming,LUAN Guo-ming,et al.Application of PET-MR image fusion to temporal lobectomy in patients with temporal lobe epilepsy[J].,2017,(06):372-375.[doi:10.13798/j.issn.1009-153X.2017.06.002]
点击复制

PET-MRI影像融合技术在颞叶癫痫手术中的应用 ()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年06期
页码:
372-375
栏目:
论著
出版日期:
2017-06-25

文章信息/Info

Title:
Application of PET-MR image fusion to temporal lobectomy in patients with temporal lobe epilepsy
文章编号:
1009-153X（2017）06-0372-04
作者:
王国福　杨　明　栾国明　钟旭光　林耀新
528000 广东佛山，中山大学附属佛山医院神经外科（王国福、钟旭光、林耀新），核医学科（杨　明）；100093 北京，首都医科大学三博脑科医院神经外科（栾国明）
通讯作者：栾国明，E-mail：luangm3@163.com
Author(s):
WANG Guo-fu1;  YANG Ming2;  LUAN Guo-ming3;  ZHONG Xu-guang1;  LIN Yao-xin1.
1. Department of Neurosurgery, Affiliated Foshan Hospital, Sun Yat-sen University, Foshan 528000, China;
2. Department of Nuclear Medicine, Affiliated Foshan Hospital, Sun Yat-sen University, Foshan 528000, China;
3. Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
关键词:
颞叶癫痫; 海马硬化; 颞前叶切除术; 正电子发射型计算机断层显像; MRI; 影像融合
Keywords:
Temporal lobe epilepsy;  Temporal lobectomy;  Positron emission computed tomography;  MRI;  Image fusion
分类号:
R 742.1; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.06.002
文献标志码:
A
摘要:
目的 探讨PET-MRI影像融合技术在海马硬化所致颞叶癫痫病人颞前叶切除范围评估中的指导价值。方法 2013年1月至2015年1月前瞻性收集手术治疗海马硬化所致单侧颞叶癫痫10例，根据PET-MRI融合影像显示的低代谢范围决定颞前叶手术切除范围。术后3个月复查PET-CT及MRI，随访1年以上，评估手术短期并发症及癫痫控制情况。结果 发作间期PET检查均表现为受累侧颞前叶低代谢，2例合并对侧颞叶代谢减低。术后病理示局灶皮层发育不良Ⅰ型8例，Ⅱ型2例。术后短期没有出现偏瘫、失语、记忆力严重下降。术后平均随访1.9年，Engel Ⅰa级8例，EngelⅠb级1例，EngelⅠc级1例。结论 海马硬化所致颞叶癫痫根据术前PET-MRI融合影像有助于精准定位颞前叶的切除范围，手术对癫痫控制效果良好。
Abstract:
Objective To evaluate the value of PET-MR image fusion to anterior temporal lobectomy in the patients with temporal lobe epilepsy caused by hippocampal sclerosis. Methods From January, 2013 to January, 2015, 10 patients with unilateral temporal lobe epilepsy caused by hippocampal sclerosis underwent surgical resection of the anterior temporal lobe according to low metabolism area showed by PET-MR image fusion. PET-CT and MRI were performed again 3 months after the operation, and the short-term complications and epilepsy control were assessed in all the patients1.9 year after the operation. Results The preoperative PET showed that there was low metabolism in the anterior temporal lobes of the affected sides in 10 patients, and the metabolism decreased in the bilateral temporal lobes in 2 patients. The postoperative pathological examination showed that there was anterior temporal lobe focal cortical dysplasia type Ⅰ in 8 patients and focal cortical dysplasia type Ⅱ in 2 patients. There were no short-term postoperative hemiplegia, aphasia and severe memory disturbance in all the patients. The epilepsy control belonged in Engel grade Ia in 8 cases, grade Ib in 1 case and grade Ic in 1 case. Conclusion The preoperative PET-MR imaging fusion is very helpful to accurate location of the extent of the anterior temporal lobectomy and can improve the control effect of the surgery on the epilepsy in the patients with temporal lobe epilepsy induced by hippocampal sclerosis.

参考文献/References:

[1] Harroud A, Bouthillier A, Weil AG, et al. Temporal lobe epilepsy surgery failures: a review [J]. Epilepsy Res Treat, 2012, 2012: 201651.
[2] Wang X, Zhang C, Wang Y, et al. Prognostic factors for seizure outcome in patients with MRI-negative temporal lobe epilepsy: a meta-analysis and systematic review [J]. Seizure, 2016, 38: 54-62.
[3] Blümcke I1, Pieper T, Pauli E, et al. A distinct variant of focal cortical dysplasia type I characterised by magnetic resonance imaging and neuropathological examination in children with severe epilepsies [J]. Epileptic Disord, 2010, 12(3): 172-180.
[4] Higo T, Sugano H, Nakajima M, et al. The predictive value of FDG-PET with 3D-SSP for surgical outcomes in patients with temporal lobe epilepsy [J]. Seizure, 2016, 41: 127-133.
[5] Guedj E, Bonini F, Gavaret M, et al. 18FDG-PET in different subtypes of temporal lobe epilepsy: SEEG validation and predictive value [J]. Epilepsia, 2015, 56(3): 414-421.
[6] Morimoto E, Okada T, Kanagaki M, et al. Evaluation of focus laterality in temporal lobe epilepsy: a quantitative study comparing double inversion-recovery MR imaging at 3T with FDG-PET [J]. Epilepsia, 2013, 54(12): 2174-2183.
[7] Feng R, Hu J, Pan L, et al. Surgical treatment of MRI- negative temporal lobe epilepsy based on PET: a retro- spective cohort study [J]. Stereotact Funct Neurosurg, 2014, 92(6): 354-359.
[8] Yang PF, Pei JS, Zhang HJ, et al. Long-term epilepsy sur- gery outcomes in patients with PET-positive, MRI-negative temporal lobe epilepsy [J]. Epilepsy Behav, 2014, 41: 91- 97.
[9] 林耀云，林志国，李　勇，等. 18F-FDG PET/CT显像对颞 叶癫痫灶定位的价值[J]. 中国临床神经外科杂志，2013， 18（2）：65-67.
[10] Lothe A, Didelot A, Hammers A, et al. Comorbidity between temporal lobe epilepsy and depression: a
[18F]MPPF PET study [J]. Brain, 2008, 131(Pt 10): 2765-2782.
[11] Wiebe S, Blume WT, Girvin JP, et al. A randomized, con- trolled trial of surgery for temporal-lobe epilepsy [J]. N Engl J Med, 2001, 345(5): 311-318.
[12] Jones AL, Cascino GD. Evidence on use of neuroimaging for surgical treatment of temporal lobe epilepsy: a systema- tic review [J]. JAMA Neurol, 2016, 73(4): 464-470.

相似文献/References:

[1]柯燕燕　周春霞　瞿建美　马丽萍.颞叶癫痫丙泊酚Wada试验中护理配合[J].中国临床神经外科杂志,2016,(06):380.[doi:10.13798/j.issn.1009-153X.2016.06.022]
[2]陈艳芳　王梦阳　翟　锋　栾国明　于思科　王　茜　周　健.前颞叶切除术对颞叶癫痫病人认知功能的影响[J].中国临床神经外科杂志,2017,(06):376.[doi:10.13798/j.issn.1009-153X.2017.06.003]
　CHEN Yan-fang,WANG Meng-yang,ZHAI Feng,et al.Effects of anterior temporal lobectomy on cognitive function in patients with temporal lobe epilepsy[J].,2017,(06):376.[doi:10.13798/j.issn.1009-153X.2017.06.003]
[3]齐雪岭　姚　坤　段泽君　翟　锋　周　健.癫痫病人海马电凝热灼术中电凝功率与海马传导纤维病理改变相关性分析[J].中国临床神经外科杂志,2017,(06):382.[doi:10.13798/j.issn.1009-153X.2017.06.005]
　QI Xue-ling,YAO Kun,DUAN Ze-jun,et al.Correlation between power of hippocampal electrocoagulation and pathological changes in hippocampal conduction fibers in patients with temporal lobe epilepsy[J].,2017,(06):382.[doi:10.13798/j.issn.1009-153X.2017.06.005]
[4]郭 坤,魏熠鑫,李云波,等.局灶性难治性颞叶癫痫全脑葡萄糖代谢特点[J].中国临床神经外科杂志,2018,(09):585.[doi:10.13798/j.issn.1009-153X.2018.09.003]
　GUO Kun,WEI Yi-xin,LI Yun-bo,et al.Characteristics of global glucose metabolism in patients with focal intractable temporal lobe epilepsy[J].,2018,(06):585.[doi:10.13798/j.issn.1009-153X.2018.09.003]
[5]贾延增　杨朋范　林　巧　裴家生　陈其钻　钟忠辉.选择性杏仁核-海马切除术对内侧颞叶癫痫病人神经心理学的影响[J].中国临床神经外科杂志,2018,(11):711.[doi:10.13798/j.issn.1009-153X.2017.11.003]
　JIA Yan-zeng,YANG Peng-fan,LIN Qiao,et al.Effects of selective amygdalohippocampectomy on neuropsychological outcomes in patients with mesial temporal lobe epilepsy[J].,2018,(06):711.[doi:10.13798/j.issn.1009-153X.2017.11.003]
[6]徐德辉　谢海涛　伍犹梁　谢学敏　余佳彬　张晓静　隋立森　赵　敏.脑灰质异位合并巨脑回及海马硬化致药物难治性癫痫1例[J].中国临床神经外科杂志,2019,(01):64.[doi:10.13798/j.issn.1009-153X.2019.01.022]
[7]张　明　魏剑波　黄志刚.颞叶癫痫发作间期PET-CT与VEEG检查对致癫灶的诊断价值比较[J].中国临床神经外科杂志,2020,(01):10.[doi:10.13798/j.issn.1009-153X.2020.01.004]
　ZHANG Ming,WEI Jian-bo,HUANG Zhi-gang..Diagnosis of epileptogenic lesions during intermission of temporal lobe epilepsy attack: PET-CT vs. VEEG[J].,2020,(06):10.[doi:10.13798/j.issn.1009-153X.2020.01.004]
[8]许　超　王　娟　刘　锋　梁洁敏　刘伟伟.下调miR-203靶向MEF2C/NF-κB抑制颞叶癫痫大鼠海马胶质细胞的活化和炎症反应[J].中国临床神经外科杂志,2021,26(06):449.[doi:10.13798/j.issn.1009-153X.2021.06.013]
　XU Chao,WANG Juan,LIU Feng,et al.Down-regulation of miR-203 inhibits glial cell activation and inflammation in hippocampal tissues of temporal lobe epilepsy rats by targeted regulation of MEF2C/NF-κB pathway[J].,2021,26(06):449.[doi:10.13798/j.issn.1009-153X.2021.06.013]
[9]刘琴宋健丁慧超管江衡吕丽辉向露陈璐璐.手术对颞叶癫痫病人认知功能的影响[J].中国临床神经外科杂志,2022,27(02):68.[doi:10.13798/j.issn.1009-153X.2022.02.002]
　LIU Qin,SONG Jian,DING Hui- chao,et al.Effect of surgery on cognitive function of patients with temporal lobe epilepsy[J].,2022,27(06):68.[doi:10.13798/j.issn.1009-153X.2022.02.002]
[10]马炜,张伟,陈隆,等.儿童期起病的颞叶癫痫术后疗效的预测因素分析[J].中国临床神经外科杂志,2022,27(10):828.[doi:10.13798/j.issn.1009-153X.2022.10.009]
　MA Wei,ZHANG Wei,CHEN Long,et al.Predictive factors for surgical outcomes of patients with childhood onset temporal lobe epilepsy[J].,2022,27(06):828.[doi:10.13798/j.issn.1009-153X.2022.10.009]

备注/Memo

备注/Memo:
基金项目：癫痫病临床医学研究北京市重点实验室资助（2014DXBL03）
更新日期/Last Update: 2017-06-25