Clinical value of MRI,interictal 18 F-FDG and 11 C-FMZ PET /CT imaging in the diagnosis of hipp-ocampal sclerosing refractory epilepsy / 中华核医学与分子影像杂志

ABSTRACT

Objective To compare the lateralization accuracy and localization accuracy of MRI, interictal 18 F-fluorodeoxyglucose(FDG)and 11 C-flumazenil(FMZ)PET/CT imaging for refractory epilepsy (REP)in patients with hippocampal sclerosis(HS).Methods A total of 41 classical HS patients (25 males,16 females;age15-61 years)with REP from General Hospital of Northern Theater Command of PLA between January 2017 and October 2018 were retrospectively analyzed.All patients underwent MRI, interictal 18 F-FDG and 11 C-FMZ PET/CT imaging,followed by the resection of epileptogenic foci.The path-ological diagnosis was taken as the gold standard.Visual and semi-quantitative analyses were used to analyze the images.The lateralization accuracy and localization accuracy of the three imaging methods for epilepto-genic foci were calculated and compared(χ2 test).Results The lateral accuracy and localization accuracy of MRI were 70.73％(29 /41)and 60.98％(25 /41),those of interictal 18 F-FDG PET/CT imaging were 78.05％(32 /41)and 70.73％(29 /41),and those of interictal 11 C-FMZ PET/CT imaging were 100％(41 /41)and 100％(41 /41),respectively.The interictal 11 C-FMZ PET/CT imaging was the best among 3 ima-ging methods(χ2 values1.976-12.902,all P<0.01).Conclusions All 3 imaging methods have their ad-vantages and limitations.The interictal 11 C-FMZ PET/CT imaging has a high value in the localization of classical HSREP,which can significantly improve the diagnostic accuracy of classical HSREP and guide clinical operation.