摘要目的 探究基于形态测定分析技术(MAP)结合脑磁图(MEG)在核磁阴性的药物难治性局灶性癫痫(MNPFE)患者致痫灶定位中的价值.方法 本研究共纳入从2015年1月至2016年12月就诊于首都医科大学宣武医院癫痫诊疗中心行脑磁图检查的MNPFE患者42例.MAP和MEG的分析过程相互独立,当MAP阳性(MAP+)区域和MEG阳性(MEG+)区域在同一脑叶内,则该MAP+区域定义为MAP+MEG+区域.MAP和MEG的分析结果分别或同时与手术预后进行相关性分析.结果 MAP的阳性检出率为69％(29/42),MAP+区域完全切除与患者术后无发作的预后有明显相关性(P=0.027);MEG的阳性检出率为100％(42/42),MEG+区域完全切除与患者术后无发作的预后无明显相关性(P=0.517);MAP+MEG+阳性检出率为43％(18/42),MAP+MEG+区域完全切除与患者术后无发作的预后有明显相关性(P=0.009).结论 反映精细结构特征的MAP技术和反映电生理特征的MEG技术相结合能有效提高MNPFE患者致痫灶定位的准确性.

abstractsObjective To investigate the value of morphometric analysis program (MAP) combined with magnetoencephalogram (MEG) in the localization of epileptogenic foci in MRI-negative pharmacoresistant focal epilepsy (MNPFE) patients.Methods A total of 42 consecutive MNPFE patients from Epilepsy center,Xuanwu Hospital,Capital Medical University from January 2015 to December 2016 were enrolled.The analysis process of MAP and magnetoencephalography (MEG) were performed independently.When the MAP+ region and the MEG+ region was in the same lobe,the MAP+ region was defined as the MAP+ MEG + region.The analysis results of MAP and MEG were used to do correlation analysis with surgical outcomes separately or simultaneously.Results The positive rate of MAP was 69％ (29/42),and the complete resection of MAP+ region was significantly associated with seizure-free outcome (P=0.027).The positive detection rate of MEG was 100％ (42/42),and there was no significant association between the complete resection of MEG+ region and seizure-free outcome (P=0.517).The positive rate of MAP + MEG + was 43％ (18/42),and the complete resection of MAP+ MEG + region was significantly associated with seizure-free outcome (P=0.009).Conclusion The combination of MAP which indicates subtle structural abnormalities and MEG which pictures electrophysiological features could probably achieve better epileptogenic foci localization in MNPFE patients.