Comparison of interictal PET MRI and EEG on the positioning of the value of intractable epilepsy.docVIP

 PAGE \* MERGEFORMAT 2 Comparison of interictal PET MRI and EEG on the positioning of the value of intractable epilepsy Author: Li Ming, Zhang Hua, well Xiaorong, Gao Guo-dong [Keywords:] attack Comparison of localizing value of interictal PET, MRI and EEG in preoperative evaluation of intractable epilepsy [Abstract] AIM: To compare the results of ictal PET, scalp Video EEG (VEEG), intracranial EEG and MRI in patients with intractable epilepsy and to explore the application value of 18FFDG PET and MRI in the localization of epileptogenic focus. METHODS: Brain imaging of 18FFDG PET, MRI and EEG was obtained in 65 patients [male 44, female 21, age averaging (30.1 ± 18.5) years] with intractable epilepsy. Fortytwo patients received surgical treatment and intracranial electrodes were placed in 13 patients. All the patients who had undergone surgery had MRI examination 1 month after surgery. Seizure control was also evaluated according to Engels classification of surgical outcome. The efficacy of PET for the localization of epileptogenic focus was compared with that of VEEG, MRI and intracranial EEG. RESULTS: ① Fiftyeight patients showed interictal focal hypometabolism, 3 patients with continuous seizure showed ictal hypermetabolism and 4 patients were normal. ② FDG PET localized the seizure foci in patients whose VEEG showed bilateral or no definite epileptoform discharge. FDG PET image demonstrated more metabolic changes than structural changes shown by MRI. ③ According to Engels classification, 71.4% (30/42) were classified as grade I, whose lesions were confirmed to be epileptogenic foci. The localization accuracy of intracranial EEG, FDG PET, VEEG and MRI for seizure foci was 96.7 %, 90.0%, 76.7% and 53.3%, with significant difference when calculated by χ 2 test (P