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目的探讨脑磁图(magnetoencephalography,MEG)、视频脑电图(video-electroencephalography,V-EEG)、单光子发射计算断层扫描(single photon emission computed tomography,SPECT)、正电子发射断层扫描(positron emission tomo-graphy,PET)技术术前定位癫致灶的准确性。方法癫手术患者73例,术前均采用MEG、V-EEG行致灶定位,其中52例加行V-EEG+蝶骨电极记录,19例加行PET致灶定位,48例加行SPECT定位。结果通过与术中皮层脑电图(ECoG)结果的比较,73例癫患者中术前MEG定位与术中ECoG致灶定位符合者66例,准确率90.41%;V-EEG定位与术中ECoG致灶定位符合者44例,准确率60.27%;52例癫行V-EEG+蝶骨电极描记,与术中ECoG致灶定位符合者34例,准确率为65.39%;19例行PET检查,与术中ECoG致灶定位符合者10例,准确率为52.63%;48例行SPECT检查,与术中ECoG致灶定位符合者23例,准确率为47.92%。MEG分别与V-EEG、V-EEG+蝶骨电极、PET、SPECT比较差异有统计学意义(P<0.05)。14例海马硬化所致颞叶癫患者,术前MEG定位与术中ECoG致灶定位符合者8例,准确率57.14%,V-EEG+蝶骨电极定位与术中ECoG致灶定位符合者12例,准确率85.71%,V-EEG+蝶骨电极与MEG比较差异有统计学意义(P<0.05)。结论MEG可提高术前致灶定位的准确率;对于颞叶内侧深部癫而言,术前定位以V-EEG+蝶骨电极记录更准确。
Objective To investigate the effects of magnetoencephalography (MEG), video-electroencephalography (V-EEG), single photon emission computed tomography (SPECT), positron emission tomography -graphy, PET) Accuracy of preoperative localization of epilepsy to foci. Methods Seventy three patients with epilepsy were enrolled in this study. MEG and V-EEG were used to locate the foci. Fifty-two patients underwent V-EEG + SPECT positioning. Results Compared with the results of ECoG, the accuracy of preoperative MEG localization in 73 cases of epilepsy was consistent with that of intraoperative ECoG in 66 cases (90.41%). V-EEG localization and operation Forty-four patients with ECoG were located in the foci with the accuracy rate of 60.27%. Fifty-two patients with epilepsy underwent V-EEG + sphenoid electrode tracing. The accuracy of ECoG coincided with that of intragastric ECoG. The accuracy was 65.39% The PET examination was performed in 10 cases, which was coincident with the location of ECoG in fistula. The accuracy rate was 52.63%. Twenty-eight cases were examined by SPECT. The accuracy was 47.92%. There was significant difference between MEG and V-EEG, V-EEG + sphenoid electrode, PET, SPECT (P <0.05). In 14 patients with temporal lobe epilepsy due to hippocampal sclerosis, the preoperative location of MEG coincided with that of intraoperative ECoG-induced foci in 8 cases, the accuracy rate was 57.14%. The localization of V-EEG + sphenoid electrode coincided with that of intraoperative ECoG 12 cases with accuracy of 85.71%. The V-EEG + sphenoid electrode had a significant difference compared with MEG (P <0.05). Conclusion MEG can improve the accuracy of preoperative localization of the foci. For the deep temporal epicardial region of the temporal lobe, preoperative localization is more accurately recorded by V-EEG + sphenoid electrode.