Year 2019, Volume 13 , Issue 4, Pages 292 - 301 2019-07-30

Epilepsi görüntülemesinde Modaliteler Arası Uyum
Intertechnique Agreement in Epilepsy Imaging

Altan Güneş [1] , Dilek Yalnızoğlu [2] , Ceren Günbey [3] , Bilge Volkan Salancı [4] , Figen Söylemezoğlu [5] , Burçak Biginer [6] , Eser Lay Ergün [7] , Güzide Turanlı [8] , Belkıs Erbaş [9] , Meral Topçu [10] , Serap Saygı [11] , Kader Karli Oğuz [12]


Amaç: Medikal tedaviye dirençli epilepsi hastalarında nöbet semiyolojisi, skalp-video elektroensefalografi, manyetik rezonans görüntülüme (MRG) ve 18-floro-2-deoksi-glukoz pozitron emisyon tomografi (FDG-PET) bulgularının değerlendirilmesi, epileptojenik odağı lokalize etmede klinik-elektroensefalografi bulguları ile nörogörüntüleme yöntemleri arasındaki uyumun değerlendirilmesi amaçlandı.

Gereç ve Yöntemler: Retrospektif olan çalışmamız hastane etik kuru onayı alınarak yapıldı. Çalışmaya, Ocak 2011 ile Ocak 2017 tarihleri arasında, klinik-elektroensefalografi bulgularına göre temporal (30 erkek, 26 kız, ortalama yaş 30,1±8,9 yıl) ve ekstra-temporal lob epilepsi (29 erkek, 23 kız, ortalama yaş 22,8±10,9 yıl) gruplarına ayrılan ardışık 108 hasta (59 erkek, 49 kız, ortalama yaş 26,6±10,5 yıl) dahil edildi. Kategorik-sayısal değişkenler t, Mann-Whitney U, McNemar veya Ki-kare testi ile analiz edildi.

Bulgular: Çalışmaya dahil edilen 108 hastanın 12’si (6 erkek, 6 kız, ortalama yaş 28,7±10,2 yıl) epilepsi cerrahisi geçirdi ve bu hastaların operasyon sonrası ortalama takip süresi 32 aydı. Klinik-elektroensefalografi bulguları ile nörogörüntüleme yöntemleri arasında en yüksek uyum (%76) hippokampal skleroz dışı anormallikler sahip temporal lob epilepsili hastalarda saptandı. MRG’de kortikal gelişimsel anormalliklere sahip hastalardaki, klinik- elektroensefalografi bulguları ile MRG arasındaki uyum (%84,2), klinik-elektroensefalografi bulguları ile FDG-PET arasındaki uyumdan (%52,6) yüksekti (p=0,010). Temporal lob epilepsilerindeki klinik-elektroensefalografi bulguları ile nörogörüntüleme yöntemleri arasındaki uyum (%48,2), ekstra-temporal lob epilepsilerine (%9,6) göre daha yüksekti (p<0,001). Opere olan hastaların takiplerine göre MRG ile FDG-PET arasında epileptojenik odağı lokalize etmede anlamlı farklılık saptanmadı (p=1).

Sonuç: FDG-PET epileptojenik odağın lokalize edilmesinde, özellikle MRG’de kortikal gelişimsel anormalliklerin saptandığı hastalarda yardımcı olamayabilir. Klinik-elektroensefalografi bulguları ile nörogörüntüleme yöntemleri arasındaki en yüksek uyum hippokampal skleroz dışı anormalliklere sahip temporal lob epilepsili hastalarda saptandı. Ekstra-temporal lob epilepsilerindeki klinik-elektroensefalografi bulguları ile nörogörüntüleme yöntemleri arasındaki düşük uyum, ekstra-temporal lob epilepsilerinin cerrahi öncesi değerlendirilmesinde, farklı yöntemlerin kullanılmasını gerektirmektedir.

Aim:To analyze seizure semiology, scalp video-electroencephalography,magnetic resonance imaging (MRI) and 18F-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) findings in patients with medically refractory epilepsy,to assess the concordance rate (CR) between clinical-electroencephalography findings (CEF) and neuroimaging studies (NS) for localizing epileptogenic foci.

Material and methods:This retrospective study included 108 consecutive patients (male/female=59/49;mean age=26.6±10.5 years) who were classified according to CEF (either temporal or extra-temporal lobe epilepsy [TLE]) between January 2011 and January 2017.Statistical analysis was performed using a t, Mann-Whitney U, McNemar, or χ2 tests.

Results:Fifty-six patients had TLE (M/F=30/26,mean age=30.1±8.9 years) and 52 had extra-TLE (M/F=29/23,mean age=22.8±10.9 years) according to CEF.12/108 patients (M/F=6/6,mean age=28.7±10.2 years) underwent epilepsy surgery and the mean postoperative follow-up period was 32 months.The highest CR between CEF and NS (76%) was found in patients with non-hippocampal sclerosis abnormality in TLE group.In patients with malformations of cortical development on MRI,the CR (84.2%) between CEF and MRI was better than those between CEF and FDG-PET (52.6%) (P=0.010).The CR between CEF and NS for TLE (48.2%) was better than for extra-TLE (9.6%) (P<0.001).No significant difference was found in the localization of the epileptogenic focus between MRI and FDG-PET according to the seizure outcome of patients (P=1).

Conclusions:FDG-PET may not help in revealing epileptic region in cases with abnormal MRI especially in malformations of cortical development.The highest CR between CEF and NS is found in TLE patients with findings inconclusive of hippocampal sclerosis.With low CR between CEF and NS in extra-TLE,meticulous use of multiple modalities is necessary for accurate pre-surgical evaluation.

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Primary Language en
Subjects General and Internal Medicine
Journal Section ORIGINAL ARTICLES
Authors

Orcid: 0000-0002-0365-1218
Author: Altan Güneş (Primary Author)
Institution: ANKARA ÇOCUK SAĞLIĞI VE HASTALIKLARI HEMATOLOJİ ONKOLOJİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
Country: Turkey


Orcid: 0000-0001-8575-9574
Author: Dilek Yalnızoğlu
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0003-2244-828X
Author: Ceren Günbey
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0002-1488-6012
Author: Bilge Volkan Salancı
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0002-8002-5165
Author: Figen Söylemezoğlu
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0001-9667-3709
Author: Burçak Biginer
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0000-0000-0000
Author: Eser Lay Ergün
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0002-2509-4651
Author: Güzide Turanlı
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0001-7291-0730
Author: Belkıs Erbaş
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0002-8982-3016
Author: Meral Topçu
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0000-0000-0002
Author: Serap Saygı
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Orcid: 0000-0002-6404-4403
Author: Kader Karli Oğuz
Institution: HACETTEPE UNIVERSITY, FACULTY OF MEDICINE
Country: Turkey


Dates

Publication Date : July 30, 2019

Bibtex @research article { tchd541114, journal = {Türkiye Çocuk Hastalıkları Dergisi}, issn = {1307-4490}, eissn = {2148-3566}, address = {Şehit Ömer Halisdemir Cad. Kurtdereli Sok. No:10 ANKARA}, publisher = {Sağlık Bilimleri Üniversitesi}, year = {2019}, volume = {13}, pages = {292 - 301}, doi = {10.12956/tchd.541114}, title = {Intertechnique Agreement in Epilepsy Imaging}, key = {cite}, author = {Güneş, Altan and Yalnızoğlu, Dilek and Günbey, Ceren and Volkan Salancı, Bilge and Söylemezoğlu, Figen and Biginer, Burçak and Lay Ergün, Eser and Turanlı, Güzide and Erbaş, Belkıs and Topçu, Meral and Saygı, Serap and Karli Oğuz, Kader} }
APA Güneş, A , Yalnızoğlu, D , Günbey, C , Volkan Salancı, B , Söylemezoğlu, F , Biginer, B , Lay Ergün, E , Turanlı, G , Erbaş, B , Topçu, M , Saygı, S , Karli Oğuz, K . (2019). Intertechnique Agreement in Epilepsy Imaging. Türkiye Çocuk Hastalıkları Dergisi , 13 (4) , 292-301 . DOI: 10.12956/tchd.541114
MLA Güneş, A , Yalnızoğlu, D , Günbey, C , Volkan Salancı, B , Söylemezoğlu, F , Biginer, B , Lay Ergün, E , Turanlı, G , Erbaş, B , Topçu, M , Saygı, S , Karli Oğuz, K . "Intertechnique Agreement in Epilepsy Imaging". Türkiye Çocuk Hastalıkları Dergisi 13 (2019 ): 292-301 <https://dergipark.org.tr/en/pub/tchd/issue/47759/541114>
Chicago Güneş, A , Yalnızoğlu, D , Günbey, C , Volkan Salancı, B , Söylemezoğlu, F , Biginer, B , Lay Ergün, E , Turanlı, G , Erbaş, B , Topçu, M , Saygı, S , Karli Oğuz, K . "Intertechnique Agreement in Epilepsy Imaging". Türkiye Çocuk Hastalıkları Dergisi 13 (2019 ): 292-301
RIS TY - JOUR T1 - Intertechnique Agreement in Epilepsy Imaging AU - Altan Güneş , Dilek Yalnızoğlu , Ceren Günbey , Bilge Volkan Salancı , Figen Söylemezoğlu , Burçak Biginer , Eser Lay Ergün , Güzide Turanlı , Belkıs Erbaş , Meral Topçu , Serap Saygı , Kader Karli Oğuz Y1 - 2019 PY - 2019 N1 - doi: 10.12956/tchd.541114 DO - 10.12956/tchd.541114 T2 - Türkiye Çocuk Hastalıkları Dergisi JF - Journal JO - JOR SP - 292 EP - 301 VL - 13 IS - 4 SN - 1307-4490-2148-3566 M3 - doi: 10.12956/tchd.541114 UR - https://doi.org/10.12956/tchd.541114 Y2 - 2019 ER -
EndNote %0 Türkiye Çocuk Hastalıkları Dergisi Intertechnique Agreement in Epilepsy Imaging %A Altan Güneş , Dilek Yalnızoğlu , Ceren Günbey , Bilge Volkan Salancı , Figen Söylemezoğlu , Burçak Biginer , Eser Lay Ergün , Güzide Turanlı , Belkıs Erbaş , Meral Topçu , Serap Saygı , Kader Karli Oğuz %T Intertechnique Agreement in Epilepsy Imaging %D 2019 %J Türkiye Çocuk Hastalıkları Dergisi %P 1307-4490-2148-3566 %V 13 %N 4 %R doi: 10.12956/tchd.541114 %U 10.12956/tchd.541114
ISNAD Güneş, Altan , Yalnızoğlu, Dilek , Günbey, Ceren , Volkan Salancı, Bilge , Söylemezoğlu, Figen , Biginer, Burçak , Lay Ergün, Eser , Turanlı, Güzide , Erbaş, Belkıs , Topçu, Meral , Saygı, Serap , Karli Oğuz, Kader . "Intertechnique Agreement in Epilepsy Imaging". Türkiye Çocuk Hastalıkları Dergisi 13 / 4 (July 2019): 292-301 . https://doi.org/10.12956/tchd.541114
AMA Güneş A , Yalnızoğlu D , Günbey C , Volkan Salancı B , Söylemezoğlu F , Biginer B , Lay Ergün E , Turanlı G , Erbaş B , Topçu M , Saygı S , Karli Oğuz K . Intertechnique Agreement in Epilepsy Imaging. Türkiye Çocuk Hast Derg. 2019; 13(4): 292-301.
Vancouver Güneş A , Yalnızoğlu D , Günbey C , Volkan Salancı B , Söylemezoğlu F , Biginer B , Lay Ergün E , Turanlı G , Erbaş B , Topçu M , Saygı S , Karli Oğuz K . Intertechnique Agreement in Epilepsy Imaging. Türkiye Çocuk Hastalıkları Dergisi. 2019; 13(4): 301-292.