首都医科大学学报 ›› 2002, Vol. 23 ›› Issue (4): 333-325.

• 临床研究 • 上一篇    下一篇

PET在颞叶癫痫术前定位诊断中的作用

孙振荣, 栾国明, 张斌   

  1. 首都医科大学附属北京天坛医院神经外科
  • 收稿日期:2001-11-14 修回日期:1900-01-01 出版日期:2002-10-15 发布日期:2002-10-15

Lateral Locatin Diagnosis Value of PET in Temporal Lobe Epilepsy

Sun Zhengrong, Luan Guoming, Zhang Bin   

  1. Neurosurgery, Beijing Tiantan Hospital, Affiliated of Capital University of Medical Sciences
  • Received:2001-11-14 Revised:1900-01-01 Online:2002-10-15 Published:2002-10-15

摘要: 为评价正电子发射断层照相术(PET)在颞叶癫痫病人术前侧别定位诊断中的意义,对20例颞叶癫痫病人术前均行脑电监测、头MRI及PET检查.脑电监测显示19例有棘波、尖波或棘慢波,1例正常;脑电异常位于一侧10例,位于双侧9例.头MRI检查显示12例正常,5例一侧海马萎缩,1例左顶枕软化灶,1例左额叶灰质异位,1例右额顶囊肿伴垂体微腺瘤.头PET检查20例均表现为局部脑组织代谢减低;一侧异常16例,双侧异常4例.20例病人手术及术后病理证实为颞叶癫痫.结果提示PET检查对于颞叶癫痫的术前定位诊断有价值,比头MRI更敏感.

关键词: 头PET, 颞叶癫痫, 手术治疗

Abstract: To study the lateral location diagnosis value of PET in temporal lobe epilepsy before operation, 20 patients with refractory temporal lobe epilepsy were investigated by EEG, MRI and PET. Nineteen of 20 patients had epileptiform discharges in EEG scalp recordings, but only one patient had normal EEG. EEG recordings showed unilateral EEG abnormal focus in 10 patients and bilateral abnormal focus in nine patients. MRI demonstrated 12 normal, five unilateral hippocampal atrophy, one left parietal occipital softening and one left frontal heterotopic gray matter and one rignt frontoparietal cyst accompanied with pituitary adenoma. PET revealed focal hypometabolism in all 20 patients, of whom 16 had unilateral abnormalities and 4 bilateral abnormalities. All patients were treated by operation, 16 patients underwent anterior temporal resection and hippocampectomy, 4 patients selective hippocampectomy. The pathologic examination showed gliosis and neuron death in resected samples. These results indicates that PET is superior to MRI in localizing diagnosis of temporal lobe epilepsy, more sensitive and reliable.

Key words: PET|temporal lobe epilepsy|operative treatment

中图分类号: