摘要
目的：探讨磁源性影像（MSI）在局灶性脑皮质发育不良（FCD）患者术前癫痫灶定位和疗效预测中的价值。方法回顾性分析2006年2月至2012年6月82例采用手术治疗的FCD难治性癫痫患者的影像和临床资料。所有患者术前均行MSI、视频脑电图（VEEG）检查，并与术中皮层脑电图（ECoG）的结果进行比较，术后进行随访及疗效评估。使用χ2检验比较术前MSI、VEEG检查与ECoG癫痫灶定位的一致性，并对定位一致的患者进行手术疗效的评估。结果术前MSI与术中ECoG比较，两者癫痫灶定位完全一致57例、部分一致14例、不一致11例。定位完全一致的57例患者中，术后随访EngelⅠ级46例、Ⅱ级3例、Ⅲ级4例、Ⅳ级4例。术前VEEG与术中ECoG比较，两者癫痫灶定位完全一致43例、部分一致33例、不一致6例。43例定位完全一致的患者进行手术疗效的评估，其中EngelⅠ级27例、Ⅱ级5例、Ⅲ级7例、Ⅳ级4例。MSI与ECoG定位完全一致率（69.51%，57/82）高于VEEG与ECoG定位完全一致率（52.44%，43/82），差异具有统计学意义（χ2=5.023，P=0.025）。MSI与术中ECoG定位完全一致患者的手术疗效高于VEEG与ECoG完全一致患者（χ2=3.989，P=0.046）。结论术前MSI对癫痫灶定位的效果优于VEEG，当MSI与ECoG癫痫灶定位完全一致时，FCD患者通过手术治疗可能够获得较好的效果。
Objective To assess the diagnostic value of magnetic source imaging（MSI） in the preoperative localization of focal cortical dysplasia（FCD）. Methods Eighty-two patients with intractable epilepsy resulting from FCD undergone preoperative assessment including MSI, video electroencephalography（VEEG） and electrocorticography（ECoG）from February 2006 to June 2012.The consistency between pre- and intra-surgical assessment was evaluated. For patients who had consistent results,postoperative curative effect was also recorded. The accuracy and predictive values of noninvasive preoperative tests were compared by χ2 test. Results For MSI and ECoG, their results were consistent in 57 cases, partially consistent in 14 cases, and inconsistent in 11 cases. In the postoperative follow-up of 57 patients with consistent results, there were 46 cases with Engel class Ⅰ, 3 cases with Engel class Ⅱ, 4 cases with Engel class Ⅲ, and 4 cases with Engel class IV. For VEEG and ECoG, the results were consistent in 43 cases, partially consistent in 33 cases, inconsistent in 6 cases.The postoperative follow-up showed that 27 cases were graded as Engel classⅠ, 5 cases as Engel classⅡ,7 cases as Engel classⅢ, and 4 cases as Engel class IV. There were statistically significant differences（χ2=5.023,P=0.025）of the concordance rate with ECoG between MSI（69.51%,57/82）and VEEG（52.44%,43/82）. In the postoperative follow-up of patients with consistent results, the curative effect was better in group MSI than in group VEEG （χ2=3.989,P=0.046）. Conclusions Preoperativelocalization by MSI shows advantage over VEEG, which meanswhen it achieves an agreement with ECoG, patients with FCD may get better prognosis from the surgical process.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2015年第2期85-88,共4页
Chinese Journal of Radiology
关键词
癫痫
磁共振成像
大脑皮质
神经系统畸形
Epilepsy
Magnetic resonance imaging
Cerebral cortex
Nervous system abnormalities
