18F-FDG PET显像与EEG在颞叶癫痫致痫灶定位价值上的对比研究

目的：通过对62例难治性癫痫患者进行前瞻性研究，对18F-FDG PET显像与EEG在颞叶癫痫致痫灶定位上的价值进行对比研究。方法：对62例临床确诊颞叶癫痫并接受手术治疗的患者进行前瞻性研究。所有患者均进行发作间期PET-CT脑显像检查和长程/视频EEG检查，细致分析图像，并将所得检查结果与术后病理进行比较，利用统计学方法对二者的诊断准确率进行对比分析。结果：18F-FDG PET显像准确定位42例癫痫患者病灶位置，头皮EEG准确定位致痫灶30例，准确率分别为67.7%及48.4%，二者比较有显著统计学差异（P<0.05）。18F-FDG PET显像结果表现较多样，影像分析应细致、审慎。结论：发作间期PET-CT脑显像检查定位颞叶癫痫致痫灶优于长程/视频EEG检查，但因其价格较昂贵，临床可首选EEG定位癫痫，EEG定位困难时选择PET显像可明显提高致痫灶定位准确性。

Comparative studies of the value of 18F-FDG PET and EEG in temporal epilepsy patients

Objective： To prospectively evaluate the efficacy of 18F-FDG PET/CT brain imaging and electroencephalogram （EEG） in preoperative localization of temporal lobe epileptic focus in 62 patients. Methods： Sixty-two patients who were clini- cally diagnosed as temporal lobe epilepsy and received surgical treatment were prospectively studied. All of those patients un- derwent interictal PET-CT brain imaging examination and long-range/video EEG examination prior to surgery. The researchers analyzed all the images and test results obtained and compared with postoperative pathology. The diagnostic accuracy between the two methods were compared and analyzed using statistical methods. Results： The rate of accuracy in locating epileptic fo- cus was 67.7%（42/62） for PET/CT brain imaging and 48.4%（30/62） for long-range or video EEG, there was significant differ- ence of accurate localization rate between the two methods （P〈0.05）. Conclusion： Interictal PET-CT brain imaging is better than long-distance/video EEG examination in preoperative localization of temporal lobe epileptic focus. PET-CT brain imaging is too expensive, so EEG can be used as the preferred method in the clinical application. PET imaging can significantly im- prove the rate of accuracy in locating epileptic focus when there are difficulties in the localization of temporal lobe epileptic focus with EEG.