Diagnostic Value of Registration Imaging 18F-FDG PET/MRI in Localization of Epileptic Foci
Objective To explore the value of 18F-FDG PET/MRI in the localization and diagnosis of epileptic foci.Methods A retrospective analysis of 41 patients diagnosed with refractory epilepsy in the Affiliated Hospital of Xuzhou Medical University from August 2018 to August 2022 was performed.All patients underwent positron emission tomography/computed tomography(18F-FDG PET/CT)and magnetic resonance imaging(MRI).Stereo-electroencephalography(SEEG)and intraoperative electrocorticography(ECoG)were used as the gold standard for diagnosis to explore the diagnostic value of 18F-FDGPET/MRI images for localization of epileptic foci.All 41 patients were intervened by surgery or intracranial nerve stimulator implantation.Results There were 23 males and 18 females in 41 patients.The positive rate of MRI imaging was 65.9％(27/41),the accuracy of lateralization was 58.5％(24/41),and the accuracy of localization was 46.3％(19/41).The positive imaging rate of 18F-FDG PET/CT was 95.1％(39/41),the accuracy of lateralization was 82.9％(34/41),and the accuracy of localization was 78.0％(32/41).The positive rate of 18F-FDG PET/MRI examination was 97.6％(40/41),the lateralization accuracy was 95.1％(39/41),and the localization accuracy was 90.2％(37/41).Among the 41 patients,there were 2 cases of nodular sclerosis,11 cases of hippocampal sclerosis,7 cases of focal cortical dysplasia(FCD),2 cases of dysembryoplastic neuroepithelial tumor(DNET)and 1 case of cavernous hemangioma,all of which were consistent with MRI reports.No definite cause was found in the remaining 18 cases.Conclusion The value of 18F-FDG PET/MRI in the detection,localization and localization of epileptic foci was higher than that of traditional MRI examination,while there was no significant difference between 18F-FDG PET/CT imaging and 18F-FDG PET/MRI fusion imaging in the positive rate of lesion detection and the accuracy of localization and localization of epileptic foci in patients with refractory epilepsy.MRI is more clear in the diagnosis of etiology.For patients with clear etiology and patients with negative MRI and positive 18F-FDG PET/CT imaging,the postoperative efficacy is good.
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