Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing FengTai Hospital, Beijing, China.
Epilepsia Open. 2024 Apr;9(2):653-664. doi: 10.1002/epi4.12903. Epub 2024 Jan 24.
Fluorine-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) is routinely used for presurgical evaluation in many epilepsy centers. Hypometabolic characteristics have been extensively examined in prior studies, but the metabolic patterns associated with specific pathological types of drug-resistant epilepsy remain to be fully defined. This study was developed to explore the relationship between metabolic patterns or characteristics and surgical outcomes in type I and II focal cortical dysplasia (FCD) patients based on results from a large cohort.
Data from individuals who underwent epilepsy surgery from 2014 to 2019 with a follow-up duration of over 3 years and a pathological classification of type I or II FCD in our hospital were retrospectively analyzed. Hypometabolic patterns were quantitatively identified via statistical parametric mapping (SPM) and qualitatively analyzed via visual examination of PET-MRI co-registration images. Univariate analyses were used to explore the relationship between metabolic patterns and surgical outcomes.
In total, this study included data from 210 patients. Following SPM calculations, four hypometabolic patterns were defined including unilobar, multi-lobar, and remote patterns as well as cases where no pattern was evident. In type II FCD patients, the unilobar pattern was associated with the best surgical outcomes (p = 0.014). In visual analysis, single gyrus (p = 0.032) and Clear-cut hypometabolism edge (p = 0.040) patterns exhibited better surgery outcomes in the type II FCD group.
PET metabolic patterns are well-correlated with the prognosis of type II FCD patients. However, similar correlations were not observed in type I FCD, potentially owing to the complex distribution of the epileptogenic region.
In this study, we demonstrated that FDG-PET was a crucial examination for patients with FCD, which was a common cause of epilepsy. We compared the surgical prognosis for patients with different hypometabolism distribution patterns and found that clear and focal abnormal region in PET was correlated with good surgical outcome in type II FCD patients.
氟-18-氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）在许多癫痫中心已被常规用于术前评估。在先前的研究中，已经广泛研究了代谢低下的特征，但与耐药性癫痫的特定病理类型相关的代谢模式仍有待充分定义。本研究旨在基于大型队列的结果，探索 I 型和 II 型局灶性皮质发育不良（FCD）患者的代谢模式或特征与手术结果之间的关系。
回顾性分析了 2014 年至 2019 年在我院接受癫痫手术且随访时间超过 3 年、病理分类为 I 型或 II 型 FCD 的患者的数据。通过统计参数映射（SPM）对代谢低下模式进行定量识别，并通过 PET-MRI 配准图像的视觉检查进行定性分析。使用单变量分析来探讨代谢模式与手术结果之间的关系。
本研究共纳入 210 例患者的数据。经 SPM 计算，共定义了四种代谢低下模式，包括单叶、多叶和远隔模式以及无模式。在 II 型 FCD 患者中，单叶模式与最佳手术结果相关（p=0.014）。在视觉分析中，单脑回（p=0.032）和清晰的代谢低下边缘（p=0.040）模式在 II 型 FCD 组中具有更好的手术效果。
PET 代谢模式与 II 型 FCD 患者的预后密切相关。然而，在 I 型 FCD 中未观察到类似的相关性，这可能是由于致痫区的复杂分布。
Zotero 插件
