PET Combined With VEEG In The Localization Of Epileptic Foci In Interact Epilepsy

Objective Via analysising the results of the interictal positron emission tomography (PET) imaging and VEEG in MRI-positive and MRI-negative group of patients with epilepsy, to explore the application value of PET in the localization of epileptogenic focus.Methods92patients performed head MRI、Interictal and ictal VEEG、interical PET combining18F—FDG and13N—NH3·H2O scans,Combined with the ictal clinical symptoms seen in the video, to lateralization and localization of epileptogenic zone. According to the structure change on MRI, they were decided into MRI-positive and MRI-negative group, comparing the PET and VEEG results between them, to analysising the positioning capabilities between the two group. Electrocorticography (ECoG) in surgery were performed in52patients who had undergone neurosurgical therapy to verify the accuracy of positioning of epileptic foci, And Combining with the postoperative follow-up to evaluate the efficacy of PET in MRI-negative group further. The results were observed for6-24months after surgery, To Evaluation the effects after surgery according to Engel criteria. Verify the accuracy of epileptogenic zone localization.Results MRI sans were normal in26cases,35cases of abnorma1.88patients had interictal epileptiform discharge abnormal (Brain regions of17cases、25cases of multiple brain areas、Hemisphere of23cases and23cases can not locate),62patients records the ictal discharge monitoring by VEEG, of which39patients focal starting. All of them had abnormal inteictal PET imaging (Brain regions of35cases、41cases of multiple brain areas、Hemisphere of5cases and11cases can not locate). no statistical significance were found in the diagnostic performance between the two agents in MRI-positive and MRI-negative group. PE、VEEG between MRI-positive and MRI-negative group were Compared independent(P<0.05),and no significant difference between the two group.comparison between PET and VEEG in MRI-positive and MRI-negative group the consequence showed ststistically significant(p>0.05),PET was better than VEEG in location the epileptogenic focus.39MRI-negative patients all had metabolic abnormalities on PET, in which10patients had the same focal abnormal with the ictal VEEG. According to Engel criteria, the postoperative and efficacy lined I, II grade with a total of14cases in21MRI-negative patients. Conclusion PET imaging is sensitive and effective in epileptic foci detection and localization,with much superiority over VEEG and MRI, When combine FDG uptake with CBF imaging, the specificity may be improved. PET were more helpful for the MRI-negative patients. and have a higher consistency with ECoG, MRI、 PET-CT、VEEG all these three checks for preoperative localization are necessary, their advantages is complementary.