Kuzniecky Ruben I, Knowlton Robert C
UAB Epilepsy Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Semin Neurol. 2002 Sep;22(3):279-88. doi: 10.1055/s-2002-36647.
Neuroimaging has an important role in the investigation and treatment of patients with epilepsy. Diagnosis of the underlying substrate in a given patient with epilepsy determines prognosis with higher accuracy than electroencephalography. Neuroimaging techniques include computed tomography (CT) and magnetic resonance imaging (MRI), although CT has a diminished role for diagnosis. MRI is the most appropriate imaging technique in the initial investigation of patients with epilepsy. MRI is the most sensitive technique for the diagnosis of hippocampal sclerosis, tumors, and malformations of cortical development. MRI is also critical for neurosurgical planning. Other imaging techniques such as positron emission tomography (PET) and single photon emission computed tomography are reserved for patients with intractable epilepsy when surgery is contemplated. New developments such as MR spectroscopy, receptor PET, and magnetic source imaging are becoming clinical tools and have the promise of improving diagnosis.
神经影像学在癫痫患者的检查和治疗中发挥着重要作用。对于特定癫痫患者，确定其潜在病变比脑电图能更准确地判断预后。神经影像学技术包括计算机断层扫描（CT）和磁共振成像（MRI），不过CT在诊断方面的作用已减弱。MRI是癫痫患者初始检查中最合适的成像技术。MRI是诊断海马硬化、肿瘤和皮质发育畸形最敏感的技术。MRI对于神经外科手术规划也至关重要。其他成像技术，如正电子发射断层扫描（PET）和单光子发射计算机断层扫描，适用于考虑手术治疗的难治性癫痫患者。诸如磁共振波谱、受体PET和磁源成像等新进展正逐渐成为临床工具，有望改善诊断。
