Abstract:

Objective  To evaluate the ¹⁸F-fluoro-2-deoxy-D-glucose (¹⁸F-FDG) PET performance of focal cortical dysplasia (FCD) without MRI abnormalities. Methods  A total of 47 cases with FCD underwent standard anterior temporal lobectomy (ATL) and hippocampectomy and were confirmed by postoperative pathological findings. Preoperative MRI showed no obvious abnormalities, and ¹⁸F-FDG PET were performed on all of them. Results  There were 26 males and 21 females, aged 9-51 years (the mean age was 24.35 years). According to postoperative pathological examinations, there were 33 cases of FCD type Ⅰ (12 cases of type Ⅰa, 8 cases of type Ⅰb and 13 cases of type Ⅰc) and 14 cases of FCD type Ⅱ (10 cases of type Ⅱ a and 4 cases of type Ⅱ b). A total of 45 cases (95.74% ) showed reduced brain metabolism in PET examination, including 37 cases of focal temporal lobe hypometabolism (located in medial temporal lobe, temporal pole and hippocampus, etc.) and 8 cases of multifocal hypometabolism (extensive hypometabolism in anterior and posterior temporal lobe). Conclusions ¹⁸F-FDG PET imaging can be taken as an adjunct diagnostic tool in temporal lobe FCD without MRI abnormalities, so it has important referential value in clinical diagnosis.

Key words: Malformations of cortical development, Epilepsy, temporal lobe, Magnetic resonance imaging, Positron-emission tomography

摘要：

目的 探讨MRI 无明显异常的局灶性皮质发育不良患者的¹⁸F-脱氧葡萄糖（¹⁸F-FDG）PET表现。方法 47 例局灶性皮质发育不良患者，术前MRI 检查未见明显异常，遂行¹⁸F-FDG PET 显像，采用标准前颞叶和海马切除术，术后经病理证实。结果 术后病理证实局灶性皮质发育不良Ⅰ型33 例，包括Ⅰa 型12 例、Ⅰb 型8 例、Ⅰc 型13 例；Ⅱ型14 例，包括Ⅱa 型10 例、Ⅱb 型4 例。47 例患者中45 例（95.74%）表现为脑组织葡萄糖代谢降低，包括颞叶局灶性低代谢37 例，分别位于颞叶内侧、颞极和海马等部位；弥漫性低代谢8 例，表现为前颞叶和后颞叶广泛性代谢降低。结论 对于MRI无明显异常的局灶性皮质发育不良患者，¹⁸F-FDG PET 显像可以作为辅助诊断手段，对临床具有重要参考价值。

关键词: 皮质发育畸形, 癫痫, 颞叶, 磁共振成像, 正电子发射断层显像术