【摘要】 目的 通过癫痫患者的皮质脑电图(electrocorticography,ECoG)与术前脑磁图(magnetoencephalography,MEG)、视频脑电图(Video electroencephalogram,V-EEG)及磁共振成像(magnetic resonance imaging,MRI)的对比性分析，探讨MEG与V-EEG对癫痫致痫灶定位诊断的临床应用价值。方法 本组122例癫痫患者术前均常规进行MEG、V-EEG和MRI检查，42例加做了蝶骨电极脑电图(Sp-EEG)，并与术中ECoG监测结果进行对比分析。结果 MEG、V-EEG、MRI与ECoG，Sp-EEG、MEG与深部电极ECoG(D-ECoG)监测结果的符合率分别为84.4%、72.1%、82.0%、88.1%和26.1%。122例MEG、V-EEG与ECoG结果符合率比较差异有显著性(P<0.05)，42例Sp-EEG、69例MEG与D-ECoG结果的符合率比较差异有非常显著性(P<0.005)。结论 MEG应用于术前癫痫致痫灶定位诊断，是一项无创、灵敏且准确性较高的检查手段，在确定致痫灶的术前评估中，MEG明显优于V-EEG，当脑电图呈泛化性改变时，MEG定位致痫灶较准确可靠，但MEG对内侧颞叶病变引起的痫样放电不够敏感，而Sp-EEG和MRI检查可弥补MEG的不足。

    【关键词】 皮质脑电图；脑磁图；视频脑电图；核磁共振；蝶骨电极脑电图；致痫灶；术前定位

    Comparison researches of ECoG with pre-operative MEG,V-EEG and MRI in patients with intractable epilepsy

    KANG Wei-li,ZHU Dan,GUAN Yu-fang,et al.

    Department of Electrophysiology Center,Guangdong 999 Brain Hospital,Guangzhou 510515,China

    【Abstract】 Objective To compare intra-operative electrocorticography (ECoG) with presurgical magnetoencephalography (MEG),video electroencephalogram (V-EEG) and magnetic resonance imaging (MRI) in the patients of in epilepsy.To explore the clinical application value of MEG,V-EEG and MRI in the location of epileptogenic focus.Methods All the patients normal regulations carries on MEG,V-EEG and the MRI examination before the operation,among them there were 42 cases added to do the sphenoid electrode EEG (Sp-EEG) testing.All the results which was then compared with ECoG findings.Results The concordance rate of MEG,V-EEG and MRI with intra-operative ECoG were 84.4%,72.1%,82.0%respectively.The concordance rate of Sp-EEG,MEG with depth electrodes ECoG (D-ECoG) were 88.1% and 26.1% respectively.There was significant difference between MEG and V-EEG (P<0.05).There was significant difference between Sp-EEG and MEG (P<0.005).Conclusion The application of MEG in the presurgical localizing diagnosis of epileptogenic focus in a non-invasive,intelligent and accurate method.MEG is more accurate than V-EEG in localizing epileptogenic focus presenting diffuse abnormality,but it is not sensitive in mesial temporal lobe epilepsy needs the help of Sp-EEG and MRI in diagnosis. ......