一致性
医学
磁共振成像
癫痫外科
正电子发射断层摄影术
危险系数
癫痫
比例危险模型
队列
多元分析
脑电图
多元统计
核医学
外科
放射科
内科学
置信区间
精神科
统计
数学
作者
Reinaldo Uribe San Martín,Roberta Di Giacomo,Roberto Mai,Francesca Gozzo,Veronica Pelliccia,Valeria Mariani,Francesco Cardinale,Ethel Ciampi,Marco Onofrj,Laura Tassi
出处
期刊:Neurosurgery
[Oxford University Press]
日期:2020-07-31
卷期号:88 (1): 113-121
被引量:3
标识
DOI:10.1093/neuros/nyaa322
摘要
Abstract BACKGROUND Accurate localization of the probable Epileptogenic Zone (EZ) from presurgical studies is crucial for achieving good prognosis in epilepsy surgery. OBJECTIVE To evaluate the degree of concordance at a sublobar localization derived from noninvasive studies (video electroencephalography, EEG; magnetic resonance imaging, MRI; 18-fluorodeoxyglucose positron emission tomography FDG-PET, FDG-PET) and EZ estimated by stereoEEG, in forecasting seizure recurrence in a long-term cohort of patients with focal drug-resistant epilepsy. METHODS We selected patients with a full presurgical evaluation and with postsurgical outcome at least 1 yr after surgery. Multivariate Cox regression analysis for seizure freedom (Engel Ia) was performed. RESULTS A total of 74 patients were included, 62.2% were in Engel class Ia with a mean follow-up of 2.8 + 2.4 yr after surgery. In the multivariate analysis for Engel Ia vs >Ib, complete resection of the EZ found in stereoEEG (hazard ratio, HR: 0.24, 95%CI: 0.09-0.63, P = .004) and full concordance between FDG-PET and stereoEEG (HR: 0.11, 95%CI: 0.02-0.65, P = .015) portended a more favorable outcome. Most of our results were maintained when analyzing subgroups of patients. CONCLUSION The degree of concordance between noninvasive studies and stereoEEG may help to forecast the likelihood of cure before performing resective surgery, particularly using a sublobar classification and comparing the affected areas in the FDG-PET with EZ identified with stereoEEG.
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