摘要目的 评价正电子发射计算机断层(PET)在MRI阴性致痫灶定位诊断中的意义.方法 对61例癫痫患者行头MRI、视频脑电图(VEEG)和发作间期18 F-FDG联合13N-NH3·H2O-PET检查,将MRI阴性手术患者术前定位与术后疗效比较,并对MRI阳性与MRI阴性两组间PET、VEEG结果进行比较.结果 MRI阴性组26例,阳性组35例；VEEG定位致痫灶提示:脑区性12例,多脑区性16例,半球性13例,不能定位20例；PET显像61例均有异常改变:脑区性23例,多脑区性28例,半球性5例,不能定位6例.17例MRI阴性患者术后Engels标准达Ⅰ～Ⅱ级的12例占70.59％,对两组间PET、VEEG定位分别进行比较,差异均无统计学意义；分别对两组的PET与VEEG比较,差异均有统计学意义.结论 PET是一种对致痫灶定位敏感性、准确性较高的功能影像检查技术,特别在MRI阴性时,PET是定位致痫灶必不可少的检查手段.

abstractsObjective To explore the application value of positron emission tomography (PET) in the localization of magnetic resonance imaging ( MRI)-negative epileptogenic focus.Methods Brain images of 18fluoro-2-deoxy-D-glucose ( 18 F-FDG) and 13 N-NH3· H2O-PET,MRI and video electroencephalography (VEEG) were obtained in 65 patients.Preoperative and postoperative localizations were compared in MRI-negative patients.And the results of PET and VEEG were compared between the MRI-positive and MRI-negative groups.Results MRI scans were normal in 26 cases and abnormal in 35 cases.Sixty-one patients had interictal epileptiform discharge on VEEG (brain regions,n =12; multiple brain areas,n =16;hemisphere,n =13; unspecified location,n =20) and interictal PET imaging (brain regions,n =23;multiple brain areas,n =28 ; hemisphere,n =5 ; unspecified location,n =6). And 17 MRI-negative patients underwent operations and 12 of them reached the Engels Ⅰ - Ⅱ level standard. Both PET and VEEG were compared between the MRI-positive and MRI-negative groups.No significant differences existed between two group (P ＜ 0.05).A comparison of PET and VEEG showed statistical significance in two group (P ＞ 0.05).Conclusion PET imaging is both sensitive and effective in the detection and localization of epileptogenic foci.Especially for MRI-negative cases,it is an indispensable tool of localizing epileptogenic foci.