关键词:癫痫;体层摄影术;发射型计算机;单光子;脑电描记术;磁共振成像;儿童
摘要 目的 评价SPECT脑血流灌注显像在小儿癫痫灶定位诊断的价值。方法 对74例发作间期、10例发作期,共84例癫痫患儿行SPECT脑血流灌注显像及EEG检查,其中67例作了MRI检查,并对各种检查结果进行比较。结果 SPECT、EEG和MRI的异常率分别为82.14%、71.43%和47.76%;EEG异常的60例患儿中与SPECT异常部位完全或基本符合率为70.59%;MRI异常的32例患儿中17例有局部病灶,其中与SPECT符合率为58.82%。结论 SPECT脑血流灌注显像是诊断小儿癫痫病灶的有效方法,灵敏度优于EEG和MRI;但SPECT所示异常范围并非都是致痫灶,应与EEG和MRI结合分析,提高其定位准确性。
Study on localization diagnosis with SPECT rCBF imaging in childhood epilepsy: incomparison with EEG and MRI findings
WU Meiqian* ,TANG Jihong,WUJinchang,et al.* Children's Hospital,Suzhou Medical College,Suzhou 215003
【Abstract】 Objective Toevaluate the diagnostic value of SPECT rCBF imaging in localization of childhood epilepticfoci.Methods rCBF imaging was performed in 74 epileptic patients not inseizure and 10 epileptic patients right in seizure.EEG was performed in 84,MRI in 67 ofthe subjects mentioned above.All the results of three modalities were compared with eachother.Results The highest positive rate (82.14%) was found in SPECTrCBF imaging,the positive rate in EEG or MRI was 71.43% or 47.76%.The epileptic focilocalized by EEG (60 abnormalities) and by MRI (32 abnormalities) were 70.59% and 58.82%in concordance with those by SPECT,respectively.Conclusions SPECT rCBFimaging is a sensitive and effective method for epileptic foci localization.It may havesome advantages over EEG and MRI in detecting and localizing epilepticfoci.However,abnormal SPECT areas may cover some abnormalities which do not belong toepileptic category.A combination of these three methods (SPECT,EEG and MRI) will improvethe positive rate and accuracy for localizing.
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