Objective To analyze the clinical value of 18F-FDG PET/MR for precise localization of epileptogenic foci in patients with refractory epilepsy.Methods From February 2019 to December 2021,81 patients(52 males,29 females;age(30.0±10.9)years)with refractory epilepsy confirmed in Ruijin Hospital Shanghai Jiao Tong University School of Medicine were retrospectively enrolled.All patients under-went preoperative PET/MR exam,and the possible position of the epileptogenic foci were determined by PET/MR imaging and pre-surgical evaluation,then the stereoelectroencephalography(SEEG)electrodes were implanted.Surgery was performed,and outcome was assessed by using a modified Engel classification two years after surgery.x2 test was used to compare the detection rates of MRI and PET/MR fusion imaging in localizing epileptogenic foci and the detection rates of epileptogenic foci in temporal lobe epilepsy(TLE)and extratemporal lobe epilepsy(ETLE)by PET/MR.Results MRI correctly localized seizure foci in 38 patients,with the detection rate of 46.91％(38/81),while PET/MR detected seizure foci in 73 patients,with the detection rate of 90.12％(73/81;x2=35.05,P＜0.001).There were 63 TLE and 18 ETLE pa-tients.The detection rate of PET/MR in localizing seizure foci in TLE patients was 95.24％(60/63),which was significantly higher than that in ETLE patients(13/18;x2=5.94,P=0.015).After 2 years follow-up,the postoperative efficacy rate of TLE patients with Engel grades Ⅰ-Ⅱ was 76.19％(48/63),which was 13/18 of ETLE patients(x2=0.12,P=0.731).Conclusion Hybrid PET/MR imaging can accurately lo-cate epileptogenic foci,especially for MRI negative lesions,which provides precision imaging information for surgical planning and improves surgical success rate.
Drug resistant epilepsyPositron-emission tomographyFluorodeoxyglucose F18Magnetic resonance imagingElectroencephalography
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