摘要
目的 探讨脑磁图 (magnetoencephalography ,MEG)对顽固性癫痫患者致痫灶定位的可行性及临床应用价值。方法 本组 6 3例患者中 ,男 4 4例 ,女 19例 ,年龄 5～ 5 2岁 (平均 2 2 .9岁 ) ,病程 1～ 2 0年 (平均 7.7年 )。所有患者术前均行MEG检查 ,同时还行了视频脑电图 (V EEG)和磁共振成像 (MRI)检查 ,将它们的检查结果与术中皮质脑电图 (ECoG)监测进行对比。结果 术前MEG、V EEG和MRI检查的阳性率分别为 81.0 % (5 1/ 6 3)、85 .7% (5 4 / 6 3)和 88.9% (5 6 / 6 3) ,三者比较差异性不显著 (P >0 .0 5 )。而术前MEG、V EEG和MRI检查与术中ECoG监测结果的符合率分别为 90 .2 % (46 / 5 1)、74 .1% (40 / 5 4 )和 76 .8% (43/ 5 6 ) ,MEG的符合率与V EEG、MRI相比较有极显著性差异 (P <0 .0 1)。MEG、V EEG和MRI三项检查的结果结合起来与术中ECoG监测结果总的符合率为 96 .8% (6 1/ 6 3)。结论 MEG是一种无创性术前致痫灶定位技术 ,其与术中ECoG检测的符合率明显高于V EEG和MRI。MEG联合V EEG和MRI等多种术前检查技术 。
Objective To explore the clinical application value and feasibility of magnetoencephalography (MEG) in the location of epileptogenec lesion.Methods There were 63 cases in this group.Among them there were 44 males and 19 females,with their age between 5 to 52 years(mean 22.9 years)and illness duration 1～20 years(mean 7.7 years).All the patients underwent MEG examination before the operation.Meanwhile,they were performed video electroencephalography (V EEG) and magnetic resonance imaging (MRI) testing.All the results were compared with intra operative electrocorticography (ECoG) monitoring.Results The positive rate of pre operative MEG?V EEG and MRI testing was 81.0%(51/63)?85.7%(54/63) and 88.9%(56/63) respectively.There was no significant difference among them( P >0.05).While the concordance rate of pre operative MEG?V EEG?MRI with intra operative ECoG was 90.2%(46/51)?74.1%(40/54) and 76.8%(43/56) respectively.There was significant difference between MEG and V EEG/MRI( P <0.01).If MEG was combined with MRI and V EEG,their concordance rate with intra operative ECoG was 96.8%(61/63).Conclusion MEG is a non invasive technique of locating epileptogenic lesion pre operatively.Its concordance rate with intra operative ECoG is much higher than V EEG/MRI.If MEG is combined with V EEG?MRI and other testing techniques,it might increase the location accuracy of epileptogenic lesion pre operatively.
出处
《立体定向和功能性神经外科杂志》
2003年第2期67-71,共5页
Chinese Journal of Stereotactic and Functional Neurosurgery
