MRI、18F-FDG和11C-FMZ PET/CT对海马硬化性难治性癫痫的诊断价值

中华核医学与分子影像杂志 Pub Date : 2019-12-25 DOI:10.3760/CMA.J.ISSN.2095-2848.2019.12.005

D. Lin, Zhiguo Wang, Guoxu Zhang

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引用次数: 0

摘要

目的比较MRI、18f -氟脱氧葡萄糖(FDG)和11c -氟马西尼(FMZ)间歇期PET/CT成像对海马硬化(HS)难治性癫痫(REP)的偏侧准确性和定位准确性。方法41例HS患者(男25例，女16例;回顾性分析2017年1月至2018年10月在解放军北部战区总医院就诊的REP患者，年龄15-61岁。所有患者均行MRI、间期18F-FDG和11C-FMZ PET/CT成像，并切除致痫灶。病理诊断为金标准。采用目视分析和半定量分析方法对图像进行分析。计算三种成像方法对致痫灶的偏侧精度和定位精度，并进行比较(χ2检验)。结果MRI的侧位正确率和定位正确率分别为70.73%(29/41)和60.98%(25/41)，18F-FDG PET/CT间期正确率分别为78.05%(32/41)和70.73%(29/41)，11C-FMZ PET/CT间期正确率分别为100%(41/41)和100%(41/41)。3种显像方式中，间隔期11C-FMZ PET/CT显像效果最好(χ2值:1.976 ~ 12.902,P均<0.01)。结论3种影像学检查方法各有优缺点。11C-FMZ间期PET/CT成像对经典HSREP的定位有很高的价值，可显著提高经典HSREP的诊断准确率，指导临床手术。关键词:癫痫;颞叶;硬化;海马状突起;正电子发射断层扫描;断层扫描，x射线计算机;Flumazenil;碳放射性同位素;脱氧葡萄糖;磁共振成像

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Clinical value of MRI, interictal 18F-FDG and 11C-FMZ PET/CT imaging in the diagnosis of hippocampal sclerosing refractory epilepsy

Objective To compare the lateralization accuracy and localization accuracy of MRI, interictal 18F-fluorodeoxyglucose(FDG) and 11C-flumazenil(FMZ) PET/CT imaging for refractory epilepsy(REP) in patients with hippocampal sclerosis(HS). Methods A total of 41 classical HS patients (25 males, 16 females; age: 15-61 years) with REP from General Hospital of Northern Theater Command of PLA between January 2017 and October 2018 were retrospectively analyzed. All patients underwent MRI, interictal 18F-FDG and 11C-FMZ PET/CT imaging, followed by the resection of epileptogenic foci. The pathological diagnosis was taken as the gold standard. Visual and semi-quantitative analyses were used to analyze the images. The lateralization accuracy and localization accuracy of the three imaging methods for epileptogenic foci were calculated and compared(χ2 test). Results The lateral accuracy and localization accuracy of MRI were 70.73%(29/41) and 60.98%(25/41), those of interictal 18F-FDG PET/CT imaging were 78.05%(32/41) and 70.73%(29/41), and those of interictal 11C-FMZ PET/CT imaging were 100%(41/41) and 100%(41/41), respectively. The interictal 11C-FMZ PET/CT imaging was the best among 3 imaging methods(χ2 values: 1.976-12.902, all P<0.01). Conclusions All 3 imaging methods have their advantages and limitations. The interictal 11C-FMZ PET/CT imaging has a high value in the localization of classical HSREP, which can significantly improve the diagnostic accuracy of classical HSREP and guide clinical operation. Key words: Epilepsy, temporal lobe; Sclerosis; Hippocampus; Positron-emission tomography; Tomography, X-ray computed; Flumazenil; Carbon radioisotopes; Deoxyglucose; Magnetic resonance imaging

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

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期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.