【摘要】 选择2013年10月～2018年12月于我院收治的53例经临床确诊的难治性癫痫患者临床资料,所有患者均于发作间期分别行常规CT、MRI、SPECT检查,观察3种方法对致痫病灶检出和定位准确率,探讨单光子发射计算机断层成像术(SPECT)、CT和MRI在难治性癫痫中的诊断价值。结果显示,SPECT检测患侧rCBF低于健侧[(46.05±7.62)vs(54.51±9.39),P<0.05],MRI检测患侧NAA(cho+Cr)低于健侧[(0.47±0.05)vs(0.69±0.11),P<0.05]。SPECT对致痫灶检出率、定位准确率分别为81.13%、73.58%,均高于MRI和常规CT(P<0.05)。联合SPECT、CT、MRI对致痫灶检出率、定位准确率达94.34%、92.45%,高于单独诊断(P<0.05),联合rCBF+NAA(cho+Cr)预测致痫病灶位置的AUC达0.923,灵敏度和特异度达82.26%、98.91%,高于rCBF、NAA(cho+Cr)(P<0.05)。结论:PET-CT、MRI对难治性癫痫术前定位均有较高临床应用价值,PET-CT在致痫灶检率、定位定侧方面更有优势,联合诊断更有助于提高定位准确率。更多还原

【Abstract】 The clinical data of 53 patients with intractable epilepsy admitted to our hospital from October 2013 to December 2018 were retrospectively selected. All patients were examined by routine CT, MRI and SPECT during the interval of epilepsy. The accuracy of detection and localization of epileptic foci by three methods was observed. To explore the diagnostic value of single-photon emission computed tomography(PET-CT), CT and MRI in intractable epilepsy. Results: The rCBFdetected by SPECT of the affected side was lower than that of the healthy side [(46.05±7.62)vs(54.51±9.39), P < 0.05]. The NAA(cho+Cr) detected by MRI of the affected side was lower than that of the healthy side [(0.47±0.05) vs(0.69±0.11), P<0.05]. The detection rate and localization accuracy of SPECT for epileptogenic focus were 81.13% and 73.58%, respectively, which were higher than those of MRI and conventional CT(P<0.05). The detection rate and localization accuracy of combined SPECT, CT and MRI were 94.34% and 92.45%, higher than that of single diagnosis(P<0.05). The AUC of rCBF + NAA(cho + Cr) in predicting the location of epileptogenic focus was 0.923, the sensitivity and specificity were 82.26% and 98.91%, higher than that of rCBFand NAA(cho + Cr)(P<0.05). Conclusion: SPECT, and MRI have high clinical value in preoperative localization of intractable epilepsy. SPECT, has more advantage in the detection rate of epileptogenic foci and localization and lateral localization. Combined diagnosis is more helpful to improve the accuracy of localization.更多还原