论文部分内容阅读
目的探讨18F-脱氧葡萄糖(FDG)PET/CT检查在颞叶内侧癫痫(mesial temporal lobe epilepsy)术前评估和致痫灶定位中的应用价值。方法回顾性分析我科实施手术治疗的85例颞叶内侧癫痫患者的临床资料,经三大检查(症状学、MRI、V-EEG)和18F-FDG PET/CT检查证实致痫灶存在且位于颞叶内侧。经上述方法精准定位后,采用扩大额颞手术切口,皮层脑电描记引导下施行标准前颞叶切除术,部分加做海马杏仁核切除术或(和)皮层热灼术,对术前评估方法,18F-FDG PET/CT检查的意义和手术治疗预后进行分析。结果 85例患者术后随访6个月到5年,Engel效果分级:69例(81.2%)I级,9例(10.6%)Ⅱ级,7例(8.2%)Ⅲ级或Ⅳ级。4例出现硬膜外血肿,15例出现短期并发症,所有病人均无永久性并发症。患者术后服用抗癫痫药物较术前减少或停药。结论 18 F-FDGPET/CT检查是目前颞叶内侧癫痫致痫灶定位精确、直观而有效的手段之一,结合常规三大术前检查,是颞叶内侧癫痫致痫灶定位可靠的无创性检查方法。18F-FDG PET/CT检查对于颞叶内侧癫痫的术前定位诊断具有重要价值。
Objective To investigate the value of 18F-FDG PET / CT in the preoperative assessment of mesial temporal lobe epilepsy and the localization of focal lesion. Methods The clinical data of 85 patients with temporal lobe medial epilepsy treated by surgery were retrospectively analyzed. The results of three major tests (Symptoms, MRI, V-EEG) and 18F-FDG PET / CT confirmed the existence of epileptic foci and were located in Medial temporal lobe. After accurate positioning of the above method, the use of an enlarged frontotemporal incision, cortical EEG under the guidance of the standard anterior temporal lobectomy, and part of the addition of hippocampus almond excision or (and) cortical cauterization, preoperative evaluation method , 18F-FDG PET / CT examination of the significance and prognosis of surgical treatment were analyzed. Results Eighty - five patients were followed up for 6 months to 5 years. The Engel effect was graded as Grade I in 69 cases (81.2%), Grade Ⅱ in 9 cases (10.6%) and Grade Ⅲ or Ⅳ in 7 cases (8.2%). 4 cases of epidural hematoma, 15 cases of short-term complications, all patients have no permanent complications. Patients taking antiepileptic drugs after surgery to reduce or discontinue the surgery. Conclusions 18 F-FDG PET / CT is one of the most accurate, effective and effective methods for locating epileptic foci of temporal lobe medial epilepsy. Combined with the conventional three major preoperative examinations, 18 F-FDG PET / CT is a reliable and noninvasive method to locate the epileptic foci of temporal lobe medial epilepsy method. 18F-FDG PET / CT examination for the diagnosis of temporal lobe medial epilepsy is of great value.