摘要
目的研究18F-FDG PET/MR联合动脉自旋标记(ASL)在癫痫患儿中定位致痫区的价值。资料与方法回顾性纳入2020年6月—2022年2月在南京市第一医院行18F-FDG PET/MR脑代谢显像的46例癫痫患儿。视觉及半定量分析MR、PET及ASL图像,以视频脑电图或手术部位为参考,分别计算MR、PET/MR、ASL/MR及PET/MR联合ASL定位致痫区的准确率。采用配对χ^(2)检验比较不同成像模式定位致痫区的价值;采用Cohen’s Kappa一致性分析比较PET与ASL定位的一致性。结果46例癫痫患儿中,MR、PET/MR及ASL/MR定位致痫灶的准确率分别为45.65%(21/46)、69.57%(32/46)、73.91%(34/46)。与单独MR比较,PET/MR及ASL/MR定位致痫区的准确率较高,差异有统计学意义(χ^(2)=9.09、11.08,P均<0.01)。PET/MR联合ASL序列定位致痫灶的准确率为76.09%(35/46),高于MR(χ^(2)=12.07,P<0.01),但与PET/MR及ASL/MR比较,差异无统计学意义(P均>0.05)。PET与ASL定位结果的一致性较强(Kappa=0.786,P<0.01)。结论18F-FDG PET/MR联合ASL对癫痫患儿致痫区定位有较好的应用价值。
Purpose To investigate the clinical value of18F-FDG PET/MR combined with arterial spin labeling(ASL)in locating epileptogenic zone in pediatric epilepsy.Materials and Methods Forty-six children with epilepsy,who underwent simultaneous18F-FDG PET/MR combined with ASL in Nanjing First Hospital from June 2020 to February 2022,were retrospectively enrolled in this study.Images of PET,MR and ASL were analyzed visually as well as semi-quantitatively by two different radiologists.Based on the results of video electroencephalogram or the surgical site,the diagnostic accuracy of MR,PET/MR,ASL/MR and PET/MR combined with ASL were analyzed separately.McNemar’s test for correlated proportions was used to compare the diagnostic accuracy of different imaging modalities in the localization of epileptogenic zone.Cohen’s Kappa consistency was used to analyze the location consistency between PET and ASL.Results Among the 46 children,the diagnostic accuracy of structure MR,PET/MR and ASL/MR were 45.65%(21/46),69.57%(32/46)and 73.91%(34/46),respectively.Compared to MR alone,the diagnostic accuracy of PET/MR and ASL/MR was significantly higher,which was of statistically significant difference(χ^(2)=9.09,11.08,both P<0.01).PET/MR combined with ASL showed a diagnostic accuracy up to 76.09%(35/46),significantly higher than that of MR,which was of statistically significant difference(χ^(2)=12.07,P<0.01),while there was no statistically significant difference compared to that of PET/MR or ASL/MR(all P>0.05).PET and ASL presented a strong consistency in the localization of epileptogenic zone(Kappa=0.786,P<0.01).Conclusion18F-FDG PET/MR combined with ASL has good clinical value for the localization of epileptic zone in pediatric epilepsy.
作者
王艳蓉
李孝媛
李如帅
艾书跃
张晓军
王峰
WANG Yanrong;LI Xiaoyuan;LI Rushuai;AI Shuyue;ZHANG Xiaojun;WANG Feng(Department of Nuclear Medicine,Nanjing Medical University Affiliated Nanjing Hospital(Nanjing First Hospital),Nanjing 210006,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第1期12-17,共6页
Chinese Journal of Medical Imaging
