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目的探讨发作间期/发作期SPECT局部脑血流灌注显像(regional cerebral blood flow,rCBF)在癫痫术前定位诊断中的价值。方法回顾性分析第三军医大学新桥医院神经外科行外科手术治疗的115例癫痫患者,术前分别行发作间期/发作期SPECT显像、常规脑电图(electroencephalogram,EEG)、视频脑电图(vedio-EEG,VEEG)、CT或MRI检查,术中行皮层脑电图(electrocorticogram,ECoG)监测,与发作间期/发作期SPECT、EEG、VEEG、CT和MRI检查结果进行比较分析。结果发作间期/发作期SPECT检出癫痫的阳性率为90.4%,高于EEG的37.4%(P<0.05)、VEEG的82.6%(P>0.05)、CT的48.8%(P<0.05)和MRI的54.2%(P<0.05)。与术中ECoG结果比较,发作间期/发作期SPECT对癫痫灶定侧率为91.3%,定位率为71.2%。结论术前发作间期/发作期SPECT显像与ECoG在癫痫灶定位诊断上具有较高的一致性,在术前综合定位诊断中具有重要意义。
Objective To investigate the value of regional cerebral blood flow imaging (rCBF) in the preoperative localization of epilepsy during the interictal / exacerbation period. Methods A retrospective analysis of 115 epilepsy patients undergoing surgical treatment in the Department of Neurosurgery, Xinqiao Hospital, Third Military Medical University was performed. Preoperative SPECT imaging, conventional electroencephalogram (EEG), video electroencephalogram The vedio-EEG, VEEG, CT or MRI examination, intraoperative cortical electrocorticogram (ECoG) monitoring were compared with the results of SPECT, EEG, VEEG, CT and MRI in seizure / exacerbation. Results The positive rate of SPECT was 90.4% in seizures / episodes, which was higher than that in EEG (37.4%, P <0.05), 82.6% (P> 0.05), 48.8% (P <0.05) 54.2% of MRI (P <0.05). Compared with the results of intraoperative ECoG, the SPECT rate of seizure / seizure was 91.3% and the localization rate was 71.2%. Conclusions SPECT imaging and preoperative eclampsia have a high consistency in the diagnosis of epileptic foci, which is of great significance in the comprehensive preoperative diagnosis.