【摘要】 目的：研究癫痫亚临床发作期和发作间期脑ＳＰＥＣＴ的痫灶定位诊断价值。方法：建立亚临床发作期脑血流灌注显像方法，与间期显像对比分析定位；并结合脑ＣＴ、ＥＥＧ、ＥＣｏＧ和疗效综合评价其痫灶定位诊断价值。结果：间期ＳＰＥＣＴ阳性率、准确率、灵敏度分别为：９０．９１％、７７．２７％、８９．４７％，亚临床发作期分别为：９５．４５％、９０．９１％、１００％，优于传统定位诊断。亚临床发作期病灶放射性摄取比值也有明显增加，ＥＣｏＧ、病检阳性率１００％，远期随访有效率９０．９１％。结论：ＳＰＣＥＴ具有较高的痫灶定位诊断价值，运用亚临床发作期显像可明显提高痫灶定位阳性率、准确性和灵敏度，表明亚临床发作期ＳＰＥＣＴ安全易行，能呈现ｒＣＢＦ增加，反映出发作期的显像特征更多还原

【Abstract】 Objetive: To study the diagnostic value of brain SPECT for localizing epileptic foci in interictal and subclinical ictal phases. Methods: The subclinical ictal imaging of cerebral blood perfusion was eeitablished. Combined with the interictal imaging as to localize the epileptic foci. And the brain CT、EEG、ECoG and surgical outcome were analyzed together to evaluate the role of brain SPECT in epileptic foci localization. Results: The ratio of positivity, accuracy and sensitivity of interical SPECT were 90.91%, 77.27% and 89.47% respectively. And those of the subclinical ictal were 95.45%, 90.91% and 100% respectively. That was superior to thetraditional methods. And the UR of epileptic foci was increased significantle in the subclinical ictal SPECT also. Conclusion: Brain SPECT demonstrated substantial higher diagnostic value for localizing epileptic foci. The subclinical ictal imaging could increase the positivity, accuracy and sensitivity obviously. The findings show: the subclinical ictal brain SPECT is safe and convinient, to some extent it can substitute the ictal imaging by increasing rCBF.更多还原