V-EEG与SPECT联合应用在顽固性癫(癎)术前致(癎)灶定位中的价值

摘要

To explove the value of VEEG and SPECT in localizing epileptogenic focus in patients with refractory epilepsy. Methods.MRI, VEEG and SPECT were performed in 103 patients with refractory epilepsy. The epileptogenic focus was judged by the results of VEEG and SPECT. The focus was confirmed with electrocorticography. Results: VEEG abnormality was found in all patients, SPECT abnormality in 95 of 103 patients. The 85/91 patients were identical with the epileptogenic focus judged by ECoG. Conclusion:It is a useful way to localize the epileptogenic foci in patients with refractory epilepsy judgen by VEEG and SPECT before operation,especially in patients with normal MRI.%目的:探讨视频脑电图(V-EEG)与单光子发射计算机断层扫描(SPECT)联合应用在顽固性癫(癎)术前致(癎)灶定位中的价值.方法:对103例顽固性癫(癎)患者,在MRI扫描的基础上,术前行V-EEG和SPECT检查,联合定位致(癎)灶,通过术中皮层脑电图(ECoG)检查验证致(癎)灶定位的准确性.结果:103例患者发作间期V-EEG检查均有异常,85例患者检查过程中有癫(癎)发作1～3次.SPECT检查异常95例,其中表现为放射性核素稀疏区86例,放射性核素浓聚区9例.术前两者联合定位致(癎)灶91例,与术中ECoG所确定的致(癎)灶部位一致者85例,符合率为93.4％.结论:术前V-EEG与SPECT的联合应用可以较准确地定位顽固性癫(癎)的致(癎)灶,该法对于MRI无异常的癫(癎)患者之术前致(癎)灶定位尤其具有重要意义.