Application of positron emission computed tomography /magnetic resonance imaging coregistration in improving epileptic foci detection rate of structural intractable epilepsy in children
10.3760/cma.j.issn.2095-428X.2018.23.015
- VernacularTitle:正电子发射计算机断层成像/磁共振成像融合技术在提高儿童结构相关难治性癫痫致痫灶检出率的应用
- Author:
Ming LIU
1
,
2
;
Taoyun JI
;
Jintang YE
;
Yan FAN
;
Xiaoyan LIU
;
Shuang WANG
;
Ye WU
;
Qingzhu LIU
;
Ruofan WANG
;
Wen WANG
;
Weike CHENG
;
Yuwu JIANG
;
Lixin CAI
Author Information
1. 100034 北京大学第一医院儿童癫痫中心
2. 100034 北京大学第一医院儿科
- Keywords:
Intractable epilepsy;
Magnetic resonance imaging;
Positron emission computed tomography;
Positron emission computed tomography/magnetic resonance imaging coregistration;
Epileptogenic zone
- From:
Chinese Journal of Applied Clinical Pediatrics
2018;33(23):1815-1819
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the predictive value of magnetic resonance imaging (MRI),positron emission computed tomography (PET)and PET/MRI coregistration in intractable epilepsy of children.Methods A retrospec-tively analysis was performed based on the surgery data at the Department of Children Epilepsy Center of Peking Univer-sity First Hospital from September 2015 to March 2016.The clinical data,surgery and follow－up study data,interictal and ictal electroencephalogram,MRI,PET and PET/MRI coregistration data were collected.By comparison with the epi-leptogenic zone designed by pre－surgical workup,the accuracy of MRI,PET and PET/MRI coregistration in detecting lesion was assessed.In the patients who had no seizure during≥1 year follow－up,their sensitivity,specificity,positive predictive value,negative predictive value of MRI,PET and PET/MRI coregistration were calculated.Results (1)A total of 62 patients underwent surgery,30 boys and 32 girls. The average age on epilepsy onset was 2. 50 years (2 days－11.70 years),and average age on surgery was 5.10 years old(0.75－15.60 years old).(2)Surgical treat-ment of 62 cases included the resection of the focal or lobar (32 cases,51.6%),and the multilobar (16 cases, 25. 8%).Hemispherotomy was done in 14 cases (22.6%).During ≥1 year follow－up,seizure outcome was Engel class Ⅰ in 57 cases (91.9%)out of the 62 patients,Engel classⅡto Engel classⅣin 1 case,3 cases,and 1 case, respectively.(3)Referred to epileptogenic zone designed by presurgical workup,MRI represented 64.5%(40/62 ca-ses)results with accordance,PET and PET/MRI coregistration was 72.5%(45/62 cases)and 85.5%(53/62 cases), respectively,and the difference was significant(χ2＝7.25,P＝0.03).(4)Based on the patients of Engel class Ⅰ, their sensitivity and specificity were 66.7%,60.0% in MRI,75.4%,60.0% in PET %,and 85.9%,80.0% in PET/MRI coregistration,respectively.(5)There were 11 ＂non－lesion＂ cases of all focal cortical dysplasia in patholo-gy,and subtle structural abnormalities were de tected in 9 cases by reviewing MRI.Conclusions PET/MRI coregistra-tion can improve lesion detection of intractable epilepsy in children.
