Research Of Video-EEG And Diffusion Tensor Imaging In Diagnosis Andlocation Of MRI-negative Epilepsy

Background:Patients with intractable epilepsy,generalized epilepsy,brain conventional,cryptogenic epilepsy use MRI to diagnose,but their MRI results were negative.It was difficult to diagnose and locate lesions,so it was necessary to adopt a more precise instrument to diagnose.Objective:To reseach the diagnosis and localization method for MRI-negative patients with epilepsy,and to provide the basis for the surgical treatment.Method:126 patients with epilepsy who were MRI-negative results of conventional MRI were selected as the study group,and 126 healthy adults as control group.Combined application of video-EEG and diffusion tensor Imaging(DTI)were used to diagnose and locate lesions.Localize the epileptogenic focus by VEEG;the changes of the white matter fiber tracts in the epileptogenic foci were observed,FA and ADC values by DTI.The relationship between the results of VEEG and DTI was analyzed.Results:(1)The results of video EEG in 126 cases of MRI patients with negative detection rate was 77.78%(98/126);the location of the epileptogenic foci in the left 39 cases,right side 43 cases,bilateral 16 cases,were detected in 28 patients.(2)Diffusion tensor imaging(DTI)showed the detection rate of epilepsy in 96.03%(121/126);the location of the lesion was 43 in the left,59 in the right and 19 in both sides.The abnormal FA values of patient was significantly lower than normal values P<0.05;and abnormal ADC value was significantly higher than normal values,p<0.05.(3)Both of the 90 patients had the same outcome of DTI lateralization and video EEG,and the consistency rate was 71.43%(90/126).Conclusions(1)In the diagnosis of epileptogenic foci in patients with conventional MRI negative epilepsy,the positive rate of VEEG is higher than 77.78%.(2)Comprehensive analysis of VEEG findings and seizure symptoms can allow most patients to obtain localization information of epileptogenic foci.(3)DTI examination showed the direction and spatial structure of the white matter fiber tracts.(4)DTI detected the pathological foci of most patients,and the location was more accurate.Moreover,the abnormalities of epileptic patients were visualized by parameter indexes.(5)VEEG combined with diffusion tensor MR DTI can localize the lesions in MRI negative epilepsy patients,improve the accuracy of localization,and have important value for the diagnosis of epilepsy.