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首页> 外文期刊>Epilepsia: Journal of the International League against Epilepsy >An assessment of MEG coherence imaging in the study of temporal lobe epilepsy.
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An assessment of MEG coherence imaging in the study of temporal lobe epilepsy.

机译：MEG相干成像在颞叶癫痫研究中的评估。

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PURPOSE: This study examines whether magnetoencephalographic (MEG) coherence imaging is more sensitive than the standard single equivalent dipole (ECD) model in lateralizing the site of epileptogenicity in patients with drug-resistant temporal lobe epilepsy (TLE). METHODS: An archival review of ECD MEG analyses of 30 presurgical patients with TLE was undertaken with data extracted subsequently for coherence analysis by a blinded reviewer for comparison of accuracy of lateralization. Postoperative outcome was assessed by Engel classification. MEG coherence images were generated from 10 min of spontaneous brain activity and compared to surgically resected brain areas outlined on each subject's magnetic resonance image (MRI). Coherence values were averaged independently for each hemisphere to ascertain the laterality of the epileptic network. Reliability between runs was established by calculating the correlation between epochs. Match rates compared the results of each of the two MEG analyses with optimal postoperative outcome. KEY FINDINGS: The ECD method provided an overall match rate of 50% (13/16 cases) for Engel class I outcomes, with 37% (11/30 cases) found to be indeterminate (i.e., no spikes identified on MEG). Coherence analysis provided an overall match rate of 77% (20/26 cases). Of 19 cases without evidence of mesial temporal sclerosis, coherence analysis correctly lateralized the side of TLE in 11 cases (58%). Sensitivity of the ECD method was 41% (indeterminate cases included) and that of the coherence method 73%, with a positive predictive value of 70% for an Engel class Ia outcome. Intrasubject coherence imaging reliability was consistent from run-to-run (correlation > 0.90) using three 10-min epochs. SIGNIFICANCE: MEG coherence analysis has greater sensitivity than the ECD method for lateralizing TLE and demonstrates reliable stability from run-to-run. It, therefore, improves upon the capability of MEG in providing further information of use in clinical decision-making where the laterality of TLE is questioned.
机译：目的：本研究检查了脑磁图（MEG）相干成像在使耐药性颞叶癫痫（TLE）患者的癫痫发生部位侧翼化方面是否比标准的单当量偶极子（ECD）模型更为敏感。方法：对30例TLE的术前患者进行ECD MEG分析的档案回顾，随后提取数据以供盲观察者进行一致性分析，以比较偏侧化的准确性。术后结果通过恩格尔分类评估。 MEG相干图像是从10分钟的自发性大脑活动生成的，并与每个受试者的磁共振图像（MRI）上概述的手术切除的大脑区域进行了比较。对每个半球独立地平均相干值，以确定癫痫网络的侧向性。通过计算历元之间的相关性来确定运行之间的可靠性。匹配率将两种MEG分析的结果与最佳术后结果进行了比较。关键发现：ECD方法对恩格尔I类结局的总体匹配率为50％（13/16例），其中37％（11/30例）被确定为不确定（即在MEG上未发现峰值）。相干分析提供了77％的整体匹配率（20/26例）。在19例无中间颞叶硬化迹象的病例中，相干分析正确地使11例TLE的一侧偏侧（58％）。 ECD方法的敏感性为41％（包括不确定的病例），而相干方法的敏感性为73％，对恩格尔Ia类结果的阳性预测值为70％。受试者之间的相干成像可靠性使用三个10分钟的时间在每次运行之间均保持一致（相关性> 0.90）。重要性：MEG相干分析比ECD方法具有更大的敏感性，可以使TLE偏侧化，并且证明了每次运行之间的可靠稳定性。因此，它改善了MEG提供进一步信息的能力，该信息可用于对TLE的偏侧性提出质疑的临床决策中。

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