PET/MRI在癫痫灶定位中的临床应用分析
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摘要
目的探讨PET/MRI在癫痫灶定位中的应用价值。方法经临床确诊癫痫患者16例,脑电图均异常,均行PET/MRI检查。检查前避免声光刺激,注射FDG休息30min后行PET显像,时间8min,再行MRI检查,并加扫海马序列,时间共约12min。检查结束后对结果进行视觉及半定量分析,结果实行双盲阅片,将PET与MRI结果进行对比分析。数据行统计学分析。结果 14例患者PET表现为一处或多处低代谢灶,2例PET显示为正常。5例MRI表现为异常信号灶,余11例均正常。PET检出14例,占87. 5%,MRI正确诊断5例,占31. 3%,PET检出率高于MRI,二者有统计学意义。二者信息互补,对癫痫灶定位可达100%。结论 PET/MRI二者具有信息互补作用,对癫痫检出及定位价值高。PET较MRI有更高的灵敏度与准确性,MRI可以显示更多致病原因。
Objective To explore the application value of PET/MRI in epileptic foci localization. Methods 16 patients withepilepsy were diagnosed by clinical examination,and the EEG was abnormal. All patients were examined by PET/MRI. Beforethe examination,they all avoided the sound and light stimulation,and after injection FDG they had 30 min rest before PET ima-ging,and then,8 min later,MRI examination would be performed. The sequence of hippocampus should be added when MRI ex-amination,the total time was about 12 min. At the end of the examination,visual and semi quantitative analysis of the results wasperformed. The results of PET and MRI were compared each other. The data were dealt with statistical analysis. Results PETshowed one or more low metabolic foci in 14 cases,and that was normal in 2 cases. MRI exhibited abnormal signal in 5 cases,and was normal in the other 11 cases. The detection rate of PET was 87. 5%,and MRI only 31. 3%. The detection rate of PETwas obviously higher than MRI. There was a significant deference between them. Complementary information through PET andMRI,the location of epilepsy foci was up to 100%. Conclusion The information from PET/MRI can be complementary. PET/MRI has a high value in the detection and location of the epileptic foci is high and positioning. PET has higher sensitivity and ac-curacy than MRI,and MRI can show more pathogenic factors.
Objective To explore the application value of PET/MRI in epileptic foci localization. Methods 16 patients withepilepsy were diagnosed by clinical examination,and the EEG was abnormal. All patients were examined by PET/MRI. Beforethe examination,they all avoided the sound and light stimulation,and after injection FDG they had 30 min rest before PET ima-ging,and then,8 min later,MRI examination would be performed. The sequence of hippocampus should be added when MRI ex-amination,the total time was about 12 min. At the end of the examination,visual and semi quantitative analysis of the results wasperformed. The results of PET and MRI were compared each other. The data were dealt with statistical analysis. Results PETshowed one or more low metabolic foci in 14 cases,and that was normal in 2 cases. MRI exhibited abnormal signal in 5 cases,and was normal in the other 11 cases. The detection rate of PET was 87. 5%,and MRI only 31. 3%. The detection rate of PETwas obviously higher than MRI. There was a significant deference between them. Complementary information through PET andMRI,the location of epilepsy foci was up to 100%. Conclusion The information from PET/MRI can be complementary. PET/MRI has a high value in the detection and location of the epileptic foci is high and positioning. PET has higher sensitivity and ac-curacy than MRI,and MRI can show more pathogenic factors.
引文
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[10]Pustina D,Avants B,Sperling M,et al.Predicting the laterality of temporal lobe epilepsy from PET,MRI,and DTI:a multimodal study[J].Neuroimage Clin,2015,9(9):20-31.
[11]Silva-Rodriguez J,Tsoumpas C,Aguiar P,et al.Resolution improvement of brain PET images using prior information from MRI:Clinical application on refractory epilepsy[J].EJNMMI Phys,2015,2(1):72.
[2]朱娅华,张春银.PET和PET/CT在难治性癫痫中的应用进展[J].中国医学影像技术,2016,32(10):1609-1612.
[3]蒋日烽,董细敏,季仲友,等.多平面重建在癫痫脑PET图像显示与定位诊断中的应用价值[J].中国医学影像技术,2013,29(4):507-510.
[4]张超,陈楠,李坤成.内侧颞叶癫痫脑微结构变化磁共振研究进展[J].中国医学影像技术,2016,32(8):1290-1293.
[5]赵春雷,陈自谦,刘耀,等.18F-FDG PET显像与EEG在颞叶癫痫致痫灶定位价值上的对比研究[J].2012,23(9):613-616.
[6]潘中允.PET诊断学[M].北京:人民出卫生出版社,2005.433-437.
[7]朱湘文,卢光明.多模态磁共振评估颞叶癫痫手术疗效[J].中国介入影像与治疗学,2013,10(2):54-57.
[8]Beril Gok,George Jallo,Reza Hayeri,Richard Wahl,Nafi Aygun,et al.The evaluation of FDG-PET imaging for epileptogenic focus localization in patients with MRI positive and MRI negative temporal lobe epilepsy[J].Neuroradiology,2013,55(5):541-550.
[9]Otto Muzik,Darshan Pai,Csaba Juhasz,et al.The need for clinical quantification of combined PET/MRI data in pediatric epilepsy[J].Nuclear Instruments and Methods in Physics Research A,2013,702(2):42-46.
[10]Pustina D,Avants B,Sperling M,et al.Predicting the laterality of temporal lobe epilepsy from PET,MRI,and DTI:a multimodal study[J].Neuroimage Clin,2015,9(9):20-31.
[11]Silva-Rodriguez J,Tsoumpas C,Aguiar P,et al.Resolution improvement of brain PET images using prior information from MRI:Clinical application on refractory epilepsy[J].EJNMMI Phys,2015,2(1):72.