摘要
目的探讨多模态影像融合联合立体脑电图对难治性癫痫患者术前定位的准确性以及手术效果。方法回顾性分析2021-01-2022-06在湖南省脑科医院行手术治疗的40例难治性癫痫患者,均口服药物效果较差,经磁共振检查确诊为阴性,基于不同的神经成像技术加以分组,其中20例行多模态影像融合为对照组,20例行多模态影像融合联合立体脑电图为观察组。对比2组患者的术前定位准确率与手术治疗效果。结果对照组和观察组阳性检出率分别为95.00%和100.0%,2组比较差异无统计学意义(P>0.05);观察组定位准确率为90.00%,显著高于对照组的75.00%(P<0.05)。观察组骨窗面积为颞叶(14.82±2.55)cm^(2),额叶(14.13±1.34)cm^(2),均显著低于对照组的(17.47±2.75)cm^(2)和(16.23±2.22)cm^(2)(P<0.05)。观察组手术时间为颞叶(3.81±0.91)h,额叶(3.53±0.64)h,顶叶(3.65±0.82)h,均显著低于对照组的(4.52±1.71)h、(4.22±1.15)h和(4.12±1.33)h(P<0.05)。观察组术后感染率为5.00%,显著低于对照组的20.00%(P<0.05)。观察组术后癫痫缓解率为95.00%,显著高于对照组的70.00%(P<0.05)。结论对于多病灶难治性癫痫手术患者,采用多模态影像融合联合立体脑电图可以提升术前定位的准确性,保证手术效果。
Objective To explore the accuracy of multimodal image fusion combined with stereotactic electroencephalography in preoperative localization and surgical efficacy for the surgical treatment of intractable epilepsy.Methods A retrospective analysis of 40 patients with intractable epilepsy who underwent surgical treatment in Hunan Brain Hospital from January 2021 to June 2022 was performed.All patients had poor oral drug effect,and were confirmed negative by magnetic resonance examination,and were grouped based on different neuroimaging techniques.Among them,20 cases of multimodal image fusion were set as the control group,and 20 cases of multimodal image fusion combined with stereoelectroencephalogram were set as the observation group.The preoperative positioning accuracy and surgical treatment effect of the two groups were compared.Results The positive detection rates of the control group and the observation group were 95.00%and 100.0%respectively,and there was no significant difference between the two groups(P>0.05).The positioning accuracy rate of the observation group was 90.00%,which was significantly higher than that of the control group(75.00%,P<0.05).The bone window areas of the observation group were(14.82±2.55)cm^(2)in temporal lobe and(14.13±1.34)cm^(2)in frontal lobe,which were significantly lower than those of the control group[(17.47±2.75)cm^(2)and(16.23±2.22)cm^(2),respectively,P<0.05],and the operation times of the observation group were(3.81±0.91)h in temporal lobe,(3.53±0.64)h in frontal lobe and(3.65±0.82)h in parietal lobe,which were significantly lower than those of the control group[(4.52±1.71)h,(4.22±1.15)h and(4.12±1.33)h,respectively,P<0.05].The postoperative infection rate of the observation group was 5.00%,which was significantly lower than that of control group(20.00%,P<0.05).The epilepsy remission rate in the observation group was 95.00%,which was significantly higher than that in the control group(70.00%,P<0.05).Conclusion For patients with intractable epilepsy with multiple foci,multimodal image fusion combined with stereoscopic EEG can improve the accuracy of preoperative positioning,ensure the surgical effect,and reflect the application value.
作者
卢军
王中鸣
王琴
彭琼
曾其昌
陈攀
黄亚辉
李振光
LU Jun;WANG Zhongming;WANG Qin;PENG Qiong;ZENG Qichang;CHEN Pan;HUANG Yahui;LI Zhenguang(Hunan Brain Hospital/Hunan Second People’s Hospital,Changsha 410007,China;School of Clinical Medicine,Hunan University of Traditional Chinese Medicine,Changsha 410007,China)
出处
《中国实用神经疾病杂志》
2023年第8期930-935,共6页
Chinese Journal of Practical Nervous Diseases
基金
湖南省临床医疗技术创新引导项目(编号:2020SK50803)。
关键词
多病灶难治性癫痫
多模态影像融合
立体脑电图
术前定位
手术效果
Multimodal image fusion
Stereo EEG
Multifocal intractable epilepsy
Preoperative localiza⁃tion
Surgical effect
