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目的 比较ＭＲＩ及ＦＤＧ－ＰＥＴ在颞叶癫癎致癎灶定位中的价值，探讨癫癎外科术前定位的方法以及手术预后的判断。方法 以手术后癫癎控制状况为标准，对３０例颞叶癫癎患者的术前ＭＲＩ和ＦＤＧ－ＰＥＴ的结果进行比较，分析ＭＲＩ及ＰＥＴ各自在癫癎致癎灶定位中的价值。结果ＭＲＩ有良好的脑结构分辨能力，对于症状性癫癎的定位价值高，当ＭＲＩ显示海马硬化时，对致癎灶定位的意义大，术后癫癎发作完全控制的可能性大。发作间期ＰＥＴ对于颞叶癫癎定位的敏感性高于ＭＲＩ，但ＰＥＴ低代谢的范围往往超过致癎灶。与ＰＥＴ的目测方法比较，ＰＥＴ半定量分析并不能提高致癎灶定位的准确性及对手术效果的预测。结论 ＭＲＩ与ＰＥＴ检查结合可以提高致癎灶定位的准确性及对手术效果的预测，减少颅内记录的应用。
Objective To compare the value of MRI and FDG-PET in the localization of temporal lobe epilepsy, and to explore the preoperative localization of epilepsy surgery and the prognosis of the operation. Methods According to the status of postoperative epilepsy control, the results of preoperative MRI and FDG-PET in 30 patients with temporal lobe epilepsy were compared. The value of MRI and PET in the localization of epilepsy was analyzed. Results MRI has good ability of brain structure resolution, high value for the location of symptomatic epilepsy. When MRI shows hippocampal sclerosis, it has great significance for localization of epileptic foci and great possibility of complete control of postoperative epileptic seizures. Interictal PET is more sensitive to temporal lobe epilepsy location than MRI, but the range of PET low metabolism often exceeds that of foci. Compared with the PET visual method, semi-quantitative PET analysis can not improve the accuracy of the localization of the foramen and the prediction of the surgical results. Conclusion The combination of MRI and PET examination can improve the accuracy of locating foci and predict the effect of surgery, and reduce the application of intracranial recording.