摘要
目的探讨磁源性影像(MSI)对脑软化灶伴有难治性癫痫发作患者癫痫灶的定位价值。方法11例脑软化灶伴有难治性癫痫的患者进行了MSI检查,将其结果与视频脑电图(VEEG)、皮质脑电图(ECoG)结果进行比较。其中5例行伽玛刀放射治疗,6例行手术治疗。结果5例伽玛刀放射治疗后,3例疗效满意,1例显著改善,1例无效,1例癫痫灶距离软化灶后方约4cm,1例脑软化灶位于右额顶叶,但其癫痫源主要位于右侧颞叶,右额叶软化灶后方只出现少量棘波,3例癫痫灶位于脑软化灶周围。6例经手术治疗的患者中,VEEG、ECoG和MSI对癫痫灶定位完全一致3例,2例ECoG确定的棘波范围均大于VEEG及MSI,1例VEEG、MSI及ECoG定侧均不一致,该患者进行了双侧枕叶癫痫灶切除术,所有手术治疗的患者疗效满意。结论MSI对脑软化灶伴有难治性癫痫发作患者癫痫灶定位准确,具有指导临床进一步治疗的价值。
Objective To evaluate the epileptic focus localization value of MSI in patients with refractory epilepsy and encephalomalacia. Method MSI examination was proceeded in 11 patients with refractory epilepsy and encephalomalacia. Five of them were treated with gamma-knife; the others were treated with surgery. Results In the five patients treated with gamma-knife, the result was satisfied in 3 patients, one patient improved significantly, the other one useless. The distance between the encephalomalacia and the epileptic focus was 4cm in one patient; one patient′s encephalomalacia was located in right frontal-parietal lobe but the epileptic focus mainly located in right temporal lobe, only a little located around the encephalomalacia. Overall agreement among VEEG,ECoG and MEG (presence of concordant spikes with the same localization shown by three techniques) was obtained in three patients, the areas localized by ECoG were larger than VEEG and MSI in two patients. The localization was different in VEEG, MSI and ECoG in one patient, then he was given a resection of bilateral occipital epileptic focus. The results of patients treated with surgery were satisfied. Conclusion The MSI localization of epileptic focus in patients with refractory epilepsy and encephalomalacia is precise, and it can direct the advanced clinical treatment.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2005年第6期634-636,共3页
Chinese Journal of Radiology
