在癫痫患者的管理中使用结构磁共振成像的建议：国际抗癫痫神经影像专题工作组的共识报告_Journal of Epilepsy

Authors：

 AndreaBernasconi , FernandoCendesm , William HTheodore , 郑舒畅　齐霜　罗洁仪　译 , 张志强　秦兵　审

Corresponding author：

AndreaBernasconi, Email: andrea.bernasconi@mcgill.ca

Keywords：

成年人; 癫痫; 儿科; 结构磁共振成像

DOI：

10.7507/2096-0247.20200026

Video：

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结构磁共振成像（MRI）对癫痫的诊断和治疗至关重要，尤其是考虑行癫痫外科治疗时。尽管以前已有一些关于癫痫 MRI 的建议及指南，但在世界范围内，结构 MRI 的方法不尽相同，无法充分发挥 MRI 新技术进步的优势造福癫痫患者。因此，国际抗癫痫联盟诊断方法委员会委托 2013-2017 年神经影像专题工作组制定了一套建议，以解决以下问题：① MRI 检查的目标患者；② 癫痫 MRI 检查方案的最低要求是什么；③ 如何评估 MRI 图像；④ 如何优化病灶的检出。这些建议针对癫痫中心的临床医生和综合性/地区性医院神经科医生制订。工作组赞同在新发的全面性和局灶性癫痫中行常规的结构成像，并在需要进行详细评估时，描述病灶的范围。工作组确定了一组以三维采集为核心、统一的癫痫结构神经成像序列—HARNESS-MRI 方案。由于这些序列在大多数 MR 扫描仪上都可用，与临床环境和国家/地区无关，因此 HARNESS-MRI 方案可推广使用。工作组还赞同使用计算机辅助图像后处理技术，客观显示个体化大脑的解剖结构和病理情况。本报告通过对 MRI 全面、深入地讨论，强调这种非侵入性检查在癫痫患者管理中的独特作用。

Citation： AndreaBernasconi, FernandoCendesm, William HTheodore, 郑舒畅　齐霜　罗洁仪　译, 张志强　秦兵　审. 在癫痫患者的管理中使用结构磁共振成像的建议：国际抗癫痫神经影像专题工作组的共识报告. Journal of Epilepsy, 2020, 6(2): 145-156. doi: 10.7507/2096-0247.20200026 Copy

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12. Bernasconi A, Bernasconi N, Bernhardt BC, et al. Advances in MRI for ‘cryptogenic’ epilepsies. Nat Rev Neurol, 2011, 7(1): 99-108.
13. So EL, Lee RW. Epilepsy surgery in MRI-negative epilepsies. Curr Opin Neurol, 2014, 27(2): 206-212.
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15. Craven IJ, Griffiths PD, Bhattacharyya D, et al. 3.0 T MRI of 2000 consecutive patients with localisation‐related epilepsy. Br J Radiol, 2012, (85): 1236-1242.
16. Craven I, Griffiths PD, Hoggard N. Magnetic resonance imaging of epilepsy at 3 Tesla. Clin Radiol, 2011, 66(2): 278-286.
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18. Griffiths PD, Coley SC, Connolly DJ, et al. MR imaging of patients with localisation‐related seizures: initial experience at 3.0 T and relevance to the NICE guidelines. Clin Radiol, 2005, 60(5): 1090-10999.
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22. Wellmer J, Quesada CM, Rothe L, et al. Proposal for a magnetic resonance imaging protocol for the detection of epileptogenic lesions at early outpatient stages. Epilepsia, 2013, 54(8): 1977-1987.
23. Krumholz A, Wiebe S, Gronseth GS, et al. Evidence‐based guideline:management of an unprovoked first seizure in adults: report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology, 2015, 84(7): 1705-1713.
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31. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017, 58(3): 512-521.
32. Wiebe S, Jette N. Pharmacoresistance and the role of surgery in difficult to treat epilepsy. Nat Rev Neurol, 2012, 8(3): 669-677.
33. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005‐2009. Epilepsia, 2010, 51(3): 676-685.
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