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目的探讨磁源性影像(MSI)对脑软化灶伴有难治性癫痫发作患者癫痫灶的定位价值。方法11例脑软化灶伴有难治性癫痫的患者进行了MSI检查,将其结果与视频脑电图(VEEG)、皮质脑电图(ECoG)结果进行比较。其中5例行伽玛刀放射治疗,6例行手术治疗。结果5例伽玛刀放射治疗后,3例疗效满意,1例显著改善,1例无效,1例癫痫灶距离软化灶后方约4cm,1例脑软化灶位于右额顶叶,但其癫痫源主要位于右侧颞叶,右额叶软化灶后方只出现少量棘波,3例癫痫灶位于脑软化灶周围。6例经手术治疗的患者中,VEEG、ECoG和MSI对癫痫灶定位完全一致3例,2例ECoG确定的棘波范围均大于VEEG及MSI,1例VEEG、MSI及ECoG定侧均不一致,该患者进行了双侧枕叶癫痫灶切除术,所有手术治疗的患者疗效满意。结论MSI对脑软化灶伴有难治性癫痫发作患者癫痫灶定位准确,具有指导临床进一步治疗的价值。
Objective To investigate the value of magnetic resonance imaging (MSI) in the location of epileptic foci in patients with cerebral foci associated with refractory seizures. Methods Eleven patients with cerebral softening complicated with refractory epilepsy were examined by MSI, and the results were compared with those of videoelectrongraphy (EEG) and cortical electroencephalogram (ECoG). Among them, 5 cases received gamma knife radiotherapy and 6 cases received surgical treatment. Results After 5 cases of gamma knife radiotherapy, the curative effect was satisfactory in 3 cases, 1 case improved significantly, 1 case was ineffective, 1 case epileptic foci located behind 4 cm behind the foci and 1 case cerebral foci located in the right frontal parietal. Mainly located in the right temporal lobe, only a small amount of spikes appear behind the right frontal lobe softening, 3 cases of epileptic foci around the brain softening. Among the 6 surgically treated patients, the location of VEEG, ECoG and MSI in epileptic foci was exactly the same in 3 cases. The spike range of 2 cases of ECoG was greater than that of VEEG and MSI, and one case of VEEG and MSI and ECoG was inconsistent Patients underwent bilateral occipital epileptic resection, the efficacy of all patients with surgical treatment satisfaction. Conclusion MSI has the accurate location of epileptic foci in patients with cerebral softening complicated refractory seizures and has the value of guiding further clinical treatment.