论文部分内容阅读
目的:分析n 18F-脱氧葡萄糖(FDG)PET/CT显像在局灶性皮质发育不良(FCD)所致颞叶癫n (TLE)及颞叶外癫n (ETLE)患者影像表现及术前定位的差异。n 方法:回顾性分析2015年4月至2018年8月间在宣武医院术前行发作间期n 18F-FDG PET/CT显像，术后病理为FCD的难治性癫n 患者71例[男45例，女26例，年龄(24.3±9.1)岁]。依据手术结果将患者分为TLE及ETLE 2组。n 18F-FDG PET/CT图像先行定性分析，并与手术结果进行比较；然后利用感兴趣区(ROI)计算每个脑区的不对称指数(AI)，用|AI|半定量评估每个脑区的代谢减低程度。术后行Engle分级随访。采用两独立样本n t检验、n χ2检验分析数据。n 结果:71例FCD患者中，TLE 35例，ETLE 36例。ETLE较TLE患者发病年龄小[(10.1±6.5)和(14.9±9.7)岁；n t＝2.48，n P＝0.02]。TLE患者中，54.29%(19/35)与手术结果完全一致，42.86%(15/35)出现颞叶外低代谢脑区；ETLE患者中，27.78%(10/36)与手术结果完全一致，47.22%(17/36)出现颞叶低代谢；TLE和ETLE患者术前定侧、定位准确性差异均有统计学意义[97.14%(34/35)和75.00%(27/36)、54.29%(19/35)和27.78%(10/36); n χ2值：7.19、6.27，均n P0.05)。n 结论:18F-FDG PET/CT在TLE患者的术前定侧准确性及定位准确性均优于ETLE患者。n “,”Objective:To analyze the differences in n 18F-fluorodeoxyglucose (FDG) PET/CT imaging and preoperative localization between patients with temporal lobe epilepsy (TLE) and extratemporal epilepsy (ETLE) caused by focal cortical dysplasia (FCD).n Methods:From April 2015 to August 2018, a total of 71 patients (45 males, 26 females, age (24.3±9.1) years) with refractory epilepsy who underwent n 18F-FDG PET/CT imaging before surgery and confirmed as FCD by pathology in Xuanwu Hospital were retrospectively analyzed. Patients were divided into TLE and ETLE groups based on pathological results. n 18F-FDG PET/CT images were analyzed qualitatively and compared with the operation result, then region of interest (ROI) was used to calculate the asymmetry index (AI), and evaluated the hypometabolism of every cerebral region by |AI| semi-quantitatively. Engle classification were followed-up after surgery. Independent-sample n t test and n χ2 test were used to analyze data.n Results:Of 71 FCD patients, 35 were TLE and 36 were ETLE. The onset age of ETLE patients were younger than TLE patients ((10.1±6.5) n vs (14.9±9.7) years; n t=2.48, n P=0.02). In TLE group, 54.29%(19/35) were completely consistent with the operation results, and 42.86%(15/35) showed hypometabolized brain regions in extratemporal lobe. In ETLE group, 27.78%(10/36) were completely consistent with the operation results, and 47.22%(17/36) showed hypometabolized brain regions in temporal lobe. There were significant differences in the lateral accuracy and positioning accuracy of n 18F-FDG PET/CT between TLE and ETLE patients (97.14%(34/35) n vs 75.00%(27/36), 54.29%(19/35) n vs 27.78%(10/36); n χ2 values: 7.19, 6.27, both n P0.05).n Conclusion:The lateral accuracy and positioning accuracy of n 18F-FDG PET/CT in TLE patients are better than that in ETLE patients.n