[1]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):10-12.[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,(01):10-12.[doi:10.13798/j.issn.1009-153X.2020.01.004]
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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()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年01期
页码:
10-12
栏目:
论著
出版日期:
2020-01-25

文章信息/Info

Title:
Diagnosis of epileptogenic lesions during intermission of temporal lobe epilepsy attack: PET-CT vs. VEEG
文章编号:
1009-153X（2020）01-0010-03
作者:
张　明　魏剑波　黄志刚
617067 四川，攀枝花市中心医院神经外科（张　明、魏剑波、黄志刚）
Author(s):
ZHANG Ming;  WEI Jian-bo;  HUANG Zhi-gang.
Department of Neurosurgery, Panzhihua Municipal Central Hospital, Panzhihua 617067, China
关键词:
颞叶癫痫; 发作间期; 正电子发射计算机断层显像; 视频脑电图; 致痫灶
Keywords:
Temporal lobe epilepsy;  Intermission of attack period;  Positron emission computed tomography;  Video electroence- phalogram;  Epileptogenic lesions;  Location
分类号:
R 742.1; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2020.01.004
文献标志码:
A
摘要:
目的 比较分析颞叶癫痫发作间期正电子发射计算机断层显像（PET-CT）和视频脑电图（VEEG）检查对致癫灶的诊断价值。方法 回顾性分析2016年3月至2018年3月手术治疗的80例单侧颞叶癫痫的临床资料。另选取同期健康体检者30例作为对照。术前进行PET-CT和VEEG监测定位致痫灶，以术中监测结果为定位致痫灶的金标准。利用受试者工作特征（ROC）曲线评价PET-CT放射性分布不对称指数（AI）对颞叶癫痫致癫灶的诊断价值。结果 PET-CT、VEEG确定致癫灶的灵敏度分别为88.73%、47.89%，特异度分别为88.89%、66.67%。颞叶癫痫发作间期病灶侧AI显著高于非病灶侧（P<0.05），同时也显著高于健康体检者颞叶内侧AI（P<0.05）及颞叶外侧AI（P<0.05）。ROC曲线分析结果显示，AI=0.153诊断颞叶癫痫致癫灶的曲线下面积为0.730，95%置信区间在0.544~0.916。结论 颞叶癫痫发作间期PET-CT脑显像定位准确率优于VEEG，对手术治疗准确定位有很高的应用价值，且AI为0.153时诊断癫痫灶的效果最好。
Abstract:
Objective To analyze the values of Positron emission computed tomography (PET) -CT and video electroencephalogram (VEEG) to the diagnosis of the epileptogenic lesions during the intermission of temporal lobe epilepsy (TLE) attack. Methods PET-CT and VEEG examinations were performed during the intermission of attack in 80 patients with unilateral TLE who were treated in our hospital from March, 2016 to March, 2018. The values of PET-CT and VEEG to preoperative localization of epileptogenic lesions were analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the value of radiological asymmetry index (AI) to the diagnosis of the epileptogenic lesions in the patients with TLE. Results The sensitivities of PET-CT and VEEG to determining epileptogenic lesions were 88.73% and 47.89% respectively. The specificities of PET-CT and VEEG to determining epileptogenic lesions were 88.89%, and 66.67% respectively. AI in the side with epileptogenic lesion was significantly higher than that of the side without epileptogenic lesion during the intermission of TLE attack in the patients with TLE. ROC analysis results showed that the area under the curve (AUC), 95%CI and Cutoff value of AI to diagnosing epileptogenic lesions were 0.730, 0.544~0.916 and 0.153 respectively. Conclusions The location of epileptogenic lesion by PET-CT is more accurate than that by VEG in the patients with TLE during the intermission of attack, and therefore, it is of very high application value for preoperative accurate positioning of epileptogenic lesions. When AI is 0.153, Yoden index for diagnosing epileptogenic lesions is the largest.

参考文献/References:

[1] 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，2018，23 （9）：14-17.
[2] 郭　韬，张　波，武　江，等. 药物难治性额叶、颞叶癫痫 患者认知功能评估及影响因素对照分析[J]. 中华神经医 学杂志，2016，15（10）：1004-1010.
[3] 赵春雷，陈自谦，钱根年，等. F-FDG PET脑显像在难治 性颞叶癫痫定侧诊断中的价值研究[J]. 临床放射学杂 志，2016，35（7）：1004-1007.
[4] Listed N. Proposal for revised classification of epilepsies and epileptic syndromes: commission on classification and ter- minology of the International League Against Epilepsy [J]. Epilepsia, 2010, 30(4):389-399.
[5] 王国福，杨　明，栾国明，等. 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， 2017，22（6）：9-12.
[6] 吴湖炳，王全师，王明芳，等. 18F-FDG PET显像对致癎灶 的定位及在外科治疗中的价值[J]. 中华核医学与分子影 像杂志，2006，26（2）：69-72.
[7] 王玉平. 脑电图检查在癫痫诊断中的应用[J]. 诊断学理论 与实践，2004，3（2）：133-136.
[8] 陈自谦，赵春雷，刘　耀，等. 18F-FDG PET/CT脑显像与 EEG用于颞叶癫痫灶术前定位[J]. 中华核医学与分子影 像杂志，2012，32（6）：166-169.
[9] 郝珊瑚，武晓丹，王治国，等. 脑18F-FDG PET/CT显像对 脑癫痫灶的定位及定侧诊断价值[J]. 中国医药导报， 2018，15（34）：149-152.
[10] 邵明岩，骆柘璜，徐　荣，等. 18F-FDG PET/CT在MRI阴 性癫痫中的诊断价值[J]. 江西医药，2018，53（9）：20-22.
[11] Lodge MA. Repeatability of SUV in Oncologic 18F-FDG PET [J]. J Nucl Med, 2017, 58(4):523-532.
[12] 匡　山，何宝明，刘晓飞，等. 颞叶癫痫患者PET-CT定量 分析研究[J]. 中风与神经疾病杂志，2013，30：974-977.

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备注/Memo

备注/Memo:
基金项目：攀枝花市科学技术和知识产权局项目（2016CY-5-5-2） （2019-07-04收稿，2019-09-17修回）
更新日期/Last Update: 2020-01-25