中华临床医师杂志（电子版） 2010年8月,4卷8期

论　著

PET/CT与脑电图和MRI对难治性癫痫的对比研究

王雪梅，赵世刚，王宏伟，高乃康，韩晓东

王雪梅，呼和浩特 内蒙古医学院附属医院核医学科，010050；赵世刚，神经内科，010050；王宏伟，伽马刀中心，010050；高乃康神经外科，010050；韩晓东，MRI中心，010050

摘要:目的　探讨正电子发射断层扫描/计算机断层成像(PET/CT)、脑电图(EEG)和磁共振成像(MRI)在难治性癫痫病灶定位方面的诊断价值。方法　2005年12月至2009年12月就诊于内蒙古医学院附属医院的50 例难治性癫痫患者，男32例，女18例，平均年龄(20±18)岁，病程平均(7±11)年，均行EEG和MRI检查及18F-FDG PET/CT(发作期PET/CT显像8例，发作间期显像42例)，并对全部病例癫痫病灶的检出率及一致性进行比较。结果　PET/CT显像异常率92%(46例)，其中低代谢灶39例，高代谢灶5例，低代谢灶和高代谢灶共存2例。EEG异常率74%(37例)，MRI异常率36%(18例)。在病灶定位诊断上PET/CT与EEG一致率为72%，PET/CT与MRI的一致率为36%，MRI与EEG的一致率为32%。结论　PET/CT显像对难治性癫痫病灶的探测敏感性高于EEG和 MRI，在病灶诊断上PET/CT与EEG一致性高于MRI与EEG。

关键词:癫痫；　正电子发射断层显像术；　脑电描记术；　磁共振成像

内蒙古自治区自然科学基金重点项目(20080404Zd29)

Comparative study on diagnosis of refractory epilepsy by PET/CT， EEG and MRI

WANG Xue-mei， ZHAO Shi-gang， WANG Hong-wei， GAO Nai-kang， HAN Xiao-dong.

Department of the Nuclear Medicine， Affiliated Hospital of Inner Mongolia Medical College，Hohhot 010050， China

Abstract:Objective　To study the diagnostic value of PET/CT， EEG and MRI for foci localization with refractory epilepsy.Methods　Fifty patients from December 2005 to December 2009 in our hospital with refractory epilepsy patients (male 32 cases， female 18 cases， age from 4 to 46， duration of disease from 5 to 25 years.All patients understood PET/CT， EEG and MRI and rate of epileptic diagnostic localization and consistency in PET/CT， EEG and MRI were analyzed and compared.Results　PET/CT positive rate was 92%， with low metabolic foci in 38 cases， high metabolic foci in 5 cases， and both in 2 case.EEG positive rate was 74%(37 cases)， MRI positive rate was 36%(18 cases).Consistency of foci diagnostic localization between PET/CT and EEG was 72%.Consistency of foci diagnostic localization between PET/CT and MRI was 36%.Consistency of foci diagnostic localization between MRI and EEG was 32%.ConclusionsPET/CT imaging is more sensitive than EEG and MRI in detecting epileptic foci of children in refractory cases.Consistency between PET/CT and EEG is well over that between MRI and EEG in foci localization.

Keywords:Epilepsy；　Positron-emission tomography；　Electroencephalography；　Magnetic resonance imaging

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(编辑：吴莹 收稿日期：2009-12-31)