Preoperative localization of 18F-FDG PET/MR in refractory epilepsy patients with negative MRI
10.3760/cma.j.cn321828-20200302-00083
- VernacularTitle:18F-FDG PET/MR对MRI阴性药物难治性癫 患者致 灶的定位价值
- Author:
Kun GUO
1
;
Kun SHANG
;
Bixiao CUI
;
Yaqin HOU
;
Hongwei YANG
;
Xiaotong FAN
;
Dongmei SHUAI
;
Jie LU
Author Information
1. 首都医科大学宣武医院核医学科，北京 100053
- Keywords:
Epilepsy;
Positron-emission tomography;
Tomography, X-ray computed;
Magnetic resonance imaging;
Deoxyglucose
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2021;41(7):410-414
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the accuracy of 18F-fluorodeoxyglucose (FDG) PET/MR in preoperative localization of refractory epilepsy patients with conventional MRI negative. Methods:From August 2016 to December 2018, 57 refractory epilepsy patients (36 males, 21 females, age (24.0±10.3) years) with conventional MRI negative who underwent surgery in Xuanwu Hospital were retrospectively enrolled. All patients received interictal 18F-FDG PET/MR before surgery and the epileptogenic foci were determined by using visual and semi-quantitative methods. Patients were followed up for 1 year and the surgical outcome was evaluated according to Engel classification. The sensitivity, specificity and accuracy of 18F-FDG PET/MR in locating epileptogenic foci were calculated according to surgical resection and followed-up results as the " gold standard" . Results:Of 57 patients, 51(89.5%, 51/57) showed single or multiple hypo-metabolism focus on 18F-FDG PET/MR, and 6(10.5%, 6/57) showed no abnormal metabolism changes. The microstructure abnormality was found in 18 patients (31.6%, 18/57) on 18F-FDG PET/MR images. Follow-up results were obtained from 46 patients, and 84.8%(39/46) with seizure improvement (Engel Ⅰ-Ⅲ). The sensitivity, specificity and accuracy of 18F-FDG PET/MR in preoperative localization of epileptic foci was 90.0%(27/30), 3/16 and 65.2%(30/46), respectively. Conclusion:18F-FDG PET/MR is helpful for the detection of epileptic foci in patients with MRI-negative refractory epilepsy, and can provide reliable information for further surgical treatment.
