【摘要】：目的:探討PET-CT、核磁共振（MRI）、視頻腦電圖（VEEG）及其聯(lián)合應(yīng)用在難治性癲癇手術(shù)術(shù)前診斷及致癇灶定位評(píng)估中的價(jià)值。 方法：回顧性收集我院神經(jīng)外科自2010年1月至2013年12月行手術(shù)治療的難治性癲癇患者的臨床資料，，包括病史、臨床癥狀、視頻腦電圖、術(shù)前核磁、PET-CT及術(shù)中ECoG檢查結(jié)果。術(shù)后隨訪復(fù)查，評(píng)估癲癇Engle預(yù)后分級(jí)。根據(jù)癲癇Engle預(yù)后分級(jí)及ECoG定位結(jié)果，分析評(píng)估PET-CT、MRI及VEEG對(duì)致癇灶的定位價(jià)值。 結(jié)果：本組19例患者全部行MRI及VEEG檢查，6例因MRI陰性或癥狀定位、影像定位與腦電定位結(jié)果不符行PET-CT檢查，全部患者在ECoG監(jiān)測(cè)下行手術(shù)治療。借助VEEG、MRI聯(lián)合癥狀學(xué)準(zhǔn)確定位致癇灶13例，PET-CT聯(lián)合VEEG、癥狀學(xué)準(zhǔn)確定位致癇灶4例，PET-CT聯(lián)合MRI、癥狀學(xué)準(zhǔn)確定位致癇灶2例。術(shù)后隨訪0.5~2年，癲癇Engle預(yù)后分級(jí)：Ⅰ級(jí)12例，Ⅱ級(jí)5例，Ⅲ級(jí)2例。 結(jié)論: VEEG及MRI可作為難治性癲癇術(shù)前定位評(píng)估最基本的檢查方式；當(dāng)MRI陰性或癥狀定位、影像學(xué)定位與腦電定位不符時(shí)，建議行PET-CT檢查。
[Abstract]:Objective: to evaluate the value of PET-CTMRI video electroencephalogram (VEEG) and its combined application in preoperative diagnosis and location evaluation of epileptogenic foci after intractable epilepsy surgery. Methods: the clinical data of patients with intractable epilepsy who underwent surgical treatment in neurosurgery from January 2010 to December 2013 were retrospectively collected, including medical history, clinical symptoms, video EEG, preoperative PET-CT and intraoperative ECoG examination. The prognosis of Epilepsy Engle was evaluated by follow-up and reexamination. The value of PET-CTT MRI and VEEG in the localization of epileptogenic foci was analyzed and evaluated according to ECoG localization and Engle grade of epilepsy. Results: all the 19 patients underwent MRI and VEEG examination, 6 cases were negative or symptomatic localization of MRI, the imaging localization was not consistent with EEG localization. All the patients underwent PET-CT under ECoG monitoring. 13 cases of epileptic foci were accurately located by VEEGT MRI combined with symptomatology, 4 cases by SET-CT combined with MRI, 2 cases by symptomatic localization of epileptic foci. Follow-up for 0.5 ~ 2 years showed that 12 cases were grade 鈪

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