脑灰质异位相关癫痫18F-FDG PET/MRI表现

目的 观察脑灰质异位（GMH）相关癫痫的¹⁸F-FDG PET/MRI表现。方法 回顾性分析27例经MRI诊断GMH癫痫患者,观察其颅脑¹⁸F-FDG PET/MRI表现、有无其他颅脑畸形并进行分型。结果 27例中,15例室管膜下GMH、2例皮质下GMH、2例层状（带状）GMH、8例混合型GMH;相比病灶周围或对侧镜像区脑白质,22例糖代谢增高、3例糖代谢减低,2例糖代谢未见明显异常;相比中央前回灰质,8例糖代谢增高、16例糖代谢减低,3例糖代谢未见明显异常。27例中,6例合并脑裂畸形,6例合并双侧小脑半球体积缩小,合并透明隔缺如及穹隆低位、胼胝体发育异常、多微小脑回畸形各1例。结论 GMH相关癫痫¹⁸F-FDG PET/MRI表现具有一定特征性,有助于临床诊断。

18F-FDG PET/MRI manifestations of gray matter heterotopia related to epilepsy

Objective To observe¹⁸F-FDG PET/MRI manifestations of gray matter heterotopia (GMH) related epilepsy. Methods Data of 27 patients with GMH and epilepsy diagnosed with MRI were retrospectively analyzed. Brain ¹⁸F-FDG PET/MRI manifestations and complicated brain malformations were observed, and the classification of GMH were performed. Results Among 27 cases, periventricular GMH, focal subcortical GMH, subcortical lamellar (band) GMH and mixed GMH were detected each in 15, 2, 2 and 8 cases, respectively. Compared with cerebral white matter around the lesion or in the contralateral mirror area of the lesion, glucose hypermetabolism and glucose hypometabolism were found in 22 and 3 cases, respectively, while glucose metabolism was normal in 2 cases. Compared with gray matter in precentral gyrus, glucose hypermetabolism and glucose hypometabolism were observed in 8 and 16 cases, respectively, while glucose metabolism was normal in 3 cases. Six cases complicated with cerebral fissure deformity, 6 cases with bilateral cerebellar hemispheric volume reduction, 1 case with absence of pellucid septum and lower fornix, 1 case with dysplasia of corpus callosum and 1 case with polymicrogyria. Conclusion ¹⁸F-FDG PET/MRI manifestations of GMH related epilepsy had certain characteristics, which were helpful for clinical diagnosis.