University of Pittsburgh Comprehensive Epilepsy Center (UPCEC), Department of Neurology, Pittsburgh, Pennsylvania, U.S.A.; and.
Magnetoencephalography Laboratory, Cleveland Clinic Epilepsy Center, Cleveland, Ohio, U.S.A.
J Clin Neurophysiol. 2020 Nov;37(6):592-598. doi: 10.1097/WNP.0000000000000693.
Broader utilization of magnetoencephalography (MEG) and optimization of clinical practice remain strategic goals of the American Clinical Magnetoencephalography Society. Despite the implementation of the first MEG Clinical Practice Guidelines, clinical adoption has been less than expected, prompting a reassessment.
Twenty-five clinical MEG centers were invited to participate anonymously in a survey of clinical practice.
Centers (N = 18) mostly operated within an academic medical center (10/18), were owned by the "hospital" (10/18), associated with a level 4 National Association of Epilepsy center (15/18), and directed by neurologists (10/18). A total of 873 (median 59) epilepsy studies, 1,179 evoked fields (of all types), and 1,607 (median 30) research MEG studies were reported. Fourteen of 17 centers serve children (median 35%), but only 5 of 14 sedate children for MEG. All (N = 14) centers record EEG simultaneous with MEG, and 57% used dipole source localization. The median reporting time for epilepsy studies was 12 and 10 days for presurgical mapping studies. Most (12/14) were favorable toward the Clinical Practice Guidelines and "formalized certification" but were against mandating the latter.
A plateau in MEG volumes suggests that MEG has not become a part of the standard of care, and correspondingly, the Clinical Practice Guidelines appeared to have had little impact on clinical practice. The American Clinical Magnetoencephalography Society must continue to engage magnetoencephalographers, potential referrers, and vendors.
更广泛地利用脑磁图（MEG）并优化临床实践仍然是美国临床脑磁图学会的战略目标。尽管实施了第一个 MEG 临床实践指南，但临床应用的效果却不如预期，因此需要重新评估。
邀请 25 个临床 MEG 中心匿名参与一项临床实践调查。
中心（N=18）主要在学术医疗中心内运营（10/18），归“医院”所有（10/18），与四级国家癫痫中心相关联（15/18），并由神经科医生指导（10/18）。共报告了 873 项（中位数 59 项）癫痫研究、1179 项诱发场（所有类型）和 1607 项（中位数 30 项）研究性 MEG 研究。17 个中心中有 14 个为儿童服务（中位数 35%），但只有 5 个中心为儿童进行 MEG 镇静。所有（N=14）中心均同时记录脑电图和 MEG，57% 使用偶极子源定位。癫痫研究的中位数报告时间为 12 天，术前映射研究为 10 天。大多数（12/14）中心对临床实践指南和“正式认证”表示赞成，但反对强制后者。
MEG 数量的增长趋于平稳，这表明 MEG 尚未成为常规护理的一部分，相应地，临床实践指南似乎对临床实践的影响有限。美国临床脑磁图学会必须继续与脑磁图学家、潜在转诊者和供应商合作。
