MRI在难治性癫痫患者致痫病灶定位中的应用及诊断价值
|
摘要
目的综合分析磁共振成像(magnetic resonance imaging,MRI)在难治性癫痫致痫病灶定位中的应用及诊断价值。方法回顾性分析2014年8月至2016年11月本院收治的123例难治性癫痫患者的临床资料,按照入院先后顺序将其随机分为脑电图(electroencephalogram,EEG)组、正电子发射断层计算机扫描(positron emission tomography-computed tomography,PET-CT)组、MRI组,每组各41例。比较三组患者的阳性诊断率和病灶准确定位率。结果 MRI组患者阳性诊断率显著高于EEG组和PET-CT组(P<0.05),PET-CT组患者阴性诊断率显著高于MRI组和EEG组(P<0.05)。MRI组病灶准确定位率显著高于EEG组和PET-CT组(P<0.05)。结论 MRI在难治性癫痫致痫病灶定位中的应用及诊断价值显著高于EEG和PET-CT。
Objective To analyze the application and diagnostic value of magnetic resonance imaging(MRI) in the localization of epileptiform lesions in patients with intractable epilepsy. Method The clinical data of 123 patients with intractable epilepsy treated in our hospital from August 2014 to November 2016 were retrospectively analyzed. All patients were randomly divided into electroencephalogram(EEG) group, positron emission tomography-computed tomography(PET-CT) group and MRI group, 41 patients in each group. The positive diagnosis rate and accurate location rate of lesions among the three groups were compared. Result The positive diagnosis rate of MRI group was significantly higher than PET-CT group and EEG group(P < 0.05). The negative diagnosis rate of PET-CT group was significantly higher than MRI group and EEG group(P < 0.05). The accurate location rate of lesions in MRI group was significantly higher than EEG group and PET-CT group(P < 0.05). Conclusion The application and diagnostic value of MRI in the localization of epileptic lesions in patients with intractable epilepsy is significantly higher than that of EEG and PET-CT.
Objective To analyze the application and diagnostic value of magnetic resonance imaging(MRI) in the localization of epileptiform lesions in patients with intractable epilepsy. Method The clinical data of 123 patients with intractable epilepsy treated in our hospital from August 2014 to November 2016 were retrospectively analyzed. All patients were randomly divided into electroencephalogram(EEG) group, positron emission tomography-computed tomography(PET-CT) group and MRI group, 41 patients in each group. The positive diagnosis rate and accurate location rate of lesions among the three groups were compared. Result The positive diagnosis rate of MRI group was significantly higher than PET-CT group and EEG group(P < 0.05). The negative diagnosis rate of PET-CT group was significantly higher than MRI group and EEG group(P < 0.05). The accurate location rate of lesions in MRI group was significantly higher than EEG group and PET-CT group(P < 0.05). Conclusion The application and diagnostic value of MRI in the localization of epileptic lesions in patients with intractable epilepsy is significantly higher than that of EEG and PET-CT.
引文
[1]邵明岩,吴晓牧,徐荣.PET-CT、MRI及EEG对发作间期难治性癫痫患者致痫灶定位的研究[J].南昌大学学报(医学版),2014,15(9):33-37.
[2]郝科技,王茜,刘献增,等.视频脑电结合半定量分析的脑血流灌注显像定位致痫灶[J].中华神经外科杂志,2014,30(6):604-607.
[3]李连,刘寿堂,韦红恩,等.在MRI、VEEG、DLM定位下手术治疗难治性癫痫[J].中华神经外科杂志,2012,28(8):813-815.
[4]赵泽仙,Wong Chong-hey,丁瑶,等.18氟-氟脱氧葡萄糖-正电子发射断层显像在评估局灶性皮质发育不良所致难治性癫痫致痫区中的应用[J].中华神经科杂志,2013,46(8):560-562.
[5]郁毅刚,李君,罗飞,等.三步法定位并多术式联用显微外科手术治疗难治性癫痫[J].临床和实验医学杂志,2013,12(16):1274-1276.
[6]王云鹏,张国君,蔡立新,等.外科手术治疗中枢神经系统感染后继发难治性癫痫的预后分析[J].实用医学杂志,2012,28(13):2140-2143.
[7]张颖,郭成生,李桂英,等.视频脑电图联合皮层脑电图对难治性癫痫的诊治价值分析[J].中国全科医学,2012,15(29):3363-3365.
[8]吕务军,蔡晓斌,樊伟强.MRI、PET-CT联合定位应用γ刀治疗脑灰质异位症癫痫患者的临床研究[J].牡丹江医学院学报,2013,34(4):16-18.
[9]任建宇,雷治华,张本亮.难治性癫痫致病灶术前定位EEG联合f MRI检查的临床研究[J].中国实用神经疾病杂志,2015,11(10):6-8.
[10]赵春雷,陈自谦,王志敏,等.正电子发射计算机体层成像-CT与静息态功能MRI在颞叶癫痫定侧中的价值[J].中华放射学杂志,2013,47(3):211-215.
[11]蓝胜勇,肖泉,徐鹏,等.难治性癫痫三级脑电监测及显微手术干预30例疗效观察[J].中国临床新医学,2013,6(6):529-531.
[12]Ibrahim GM,Fallah A,Snead OC 3rd,et al.The use of high frequency oscillations to guide neocortical resections in children with medically-intractable epilepsy:How do we ethically apply surgical innovations to patient care?[J].Seizure,2012,21(10):743-747.
[13]Heck CN,King-Stephens D,Massey AD,et al.Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation:Final results of the RNS System Pivotal trial[J].Epilepsia,2014,55(3):432-441.
[14]Riney CJ,Chong WK,Clark CA,et al.Voxel based morph ometry of FLAIR MRI in children with intractable focal epilepsy Impli cations for surgical intervention[J].Eur J Radiol,2012,81(6):1299-1305.
[15]Patel KS,Labar DR,Gordon CM,et al.Efficacy of vagus nerve stimulation as a treatment for medically intractable epilepsy in brain tumor patients.A case-controlled study using the VNS therapy Patient Outcome Registry[J].Seizure,2013,22(8):627-633.
[16]刘献增,梁冶矢.难治性癫痫的发病机制与治疗对策[J].山东医药,2012,52(8):2-5.
[17]孟曙庆,张洪.难治性癫痫的治疗进展[J].中华临床医师杂志(电子版),2013,11(15):7115-7119.
[18]邓宇虹,周锦华,黎冰梅,等.添加生酮饮食治疗难治性癫痫的长期保留率和不良反应[J].肠外与肠内营养,2012,19(6):355-358.
[19]刘红军,尚丽,余五珍,等.药物难治性癫痫MRI表现与脑电图及病理对照研究[J].中国生化药物杂志,2017,37(10):421-422.
[20]刘海波,杨中鑫,范英俊,等.颞叶癫痫患者脑部病理改变与EF-Tumt、EF-Tsmt表达情况分析[J].中国医学前沿杂志(电子版),2017,9(3):128-131.
[2]郝科技,王茜,刘献增,等.视频脑电结合半定量分析的脑血流灌注显像定位致痫灶[J].中华神经外科杂志,2014,30(6):604-607.
[3]李连,刘寿堂,韦红恩,等.在MRI、VEEG、DLM定位下手术治疗难治性癫痫[J].中华神经外科杂志,2012,28(8):813-815.
[4]赵泽仙,Wong Chong-hey,丁瑶,等.18氟-氟脱氧葡萄糖-正电子发射断层显像在评估局灶性皮质发育不良所致难治性癫痫致痫区中的应用[J].中华神经科杂志,2013,46(8):560-562.
[5]郁毅刚,李君,罗飞,等.三步法定位并多术式联用显微外科手术治疗难治性癫痫[J].临床和实验医学杂志,2013,12(16):1274-1276.
[6]王云鹏,张国君,蔡立新,等.外科手术治疗中枢神经系统感染后继发难治性癫痫的预后分析[J].实用医学杂志,2012,28(13):2140-2143.
[7]张颖,郭成生,李桂英,等.视频脑电图联合皮层脑电图对难治性癫痫的诊治价值分析[J].中国全科医学,2012,15(29):3363-3365.
[8]吕务军,蔡晓斌,樊伟强.MRI、PET-CT联合定位应用γ刀治疗脑灰质异位症癫痫患者的临床研究[J].牡丹江医学院学报,2013,34(4):16-18.
[9]任建宇,雷治华,张本亮.难治性癫痫致病灶术前定位EEG联合f MRI检查的临床研究[J].中国实用神经疾病杂志,2015,11(10):6-8.
[10]赵春雷,陈自谦,王志敏,等.正电子发射计算机体层成像-CT与静息态功能MRI在颞叶癫痫定侧中的价值[J].中华放射学杂志,2013,47(3):211-215.
[11]蓝胜勇,肖泉,徐鹏,等.难治性癫痫三级脑电监测及显微手术干预30例疗效观察[J].中国临床新医学,2013,6(6):529-531.
[12]Ibrahim GM,Fallah A,Snead OC 3rd,et al.The use of high frequency oscillations to guide neocortical resections in children with medically-intractable epilepsy:How do we ethically apply surgical innovations to patient care?[J].Seizure,2012,21(10):743-747.
[13]Heck CN,King-Stephens D,Massey AD,et al.Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation:Final results of the RNS System Pivotal trial[J].Epilepsia,2014,55(3):432-441.
[14]Riney CJ,Chong WK,Clark CA,et al.Voxel based morph ometry of FLAIR MRI in children with intractable focal epilepsy Impli cations for surgical intervention[J].Eur J Radiol,2012,81(6):1299-1305.
[15]Patel KS,Labar DR,Gordon CM,et al.Efficacy of vagus nerve stimulation as a treatment for medically intractable epilepsy in brain tumor patients.A case-controlled study using the VNS therapy Patient Outcome Registry[J].Seizure,2013,22(8):627-633.
[16]刘献增,梁冶矢.难治性癫痫的发病机制与治疗对策[J].山东医药,2012,52(8):2-5.
[17]孟曙庆,张洪.难治性癫痫的治疗进展[J].中华临床医师杂志(电子版),2013,11(15):7115-7119.
[18]邓宇虹,周锦华,黎冰梅,等.添加生酮饮食治疗难治性癫痫的长期保留率和不良反应[J].肠外与肠内营养,2012,19(6):355-358.
[19]刘红军,尚丽,余五珍,等.药物难治性癫痫MRI表现与脑电图及病理对照研究[J].中国生化药物杂志,2017,37(10):421-422.
[20]刘海波,杨中鑫,范英俊,等.颞叶癫痫患者脑部病理改变与EF-Tumt、EF-Tsmt表达情况分析[J].中国医学前沿杂志(电子版),2017,9(3):128-131.