Abstract: Objective　To compare the clinical diagnostic effects of 3D high-resolution magnetic resonance imaging (MRI) and video electroencephalogram (VEEG), and to explore the potential application value of 3D high-resolution MRI in the clinical diagnosis of patients with epilepsy. Methods　The data of 80 patients with suspected epilepsy treated in Liaocheng Third People's Hospital were retrospectively analyzed. There were 46 males and 34 females, and they were (35.22±7.35) years old. All the patients underwent 3D high-resolution MRI and VEEG. The postoperative pathological examination was taken as the gold standard. The diagnostic consistencies, detection rates of lesion localization, and fractional anisotropy (FA) and mean apparent diffusion coefficients (ADC) of the thalamus on the affected and the healthy sides by 3D high-resolution MRI and VEEG in the diagnosis of epilepsy were analyzed. The measurement data were compared between the groups by independent-sample t test, and the enumeration data by χ² test. Results　The pathological examination of 80 patients showed there were 73 positive cases and 7 negative cases. The accuracy rate and Kappa value of 3D high-resolution MRI in the diagnosis of epilepsy were 96.25% (77/80) and 0.78, and those of VEEG were 97.50% (78/80) and 0.84, and the diagnostic results of the two methods were highly consistent (both Kappa values>0.75). The accuracy rates of unilateral and bilateral lesion detection of 3D high-resolution MRI were 96.67% (58/60) and 76.92% (10/13), and those of VEEG were 98.33% (59/60) and 92.31% (12/13), and there was no statistical difference in the total detection rate between the two methods (P>0.05). The FA and ADC on the healthy side of the patients with unilateral involvement were significantly lower than those on the affected side (both P<0.05). Conclusion　3D high-resolution MRI has a high diagnostic value on epilepsy, and can clearly display the lesion location and be used for disease diagnosis, preoperative references, and prognosis analysis.

Key words: 3D high-resolution magnetic resonance imaging, Video electroencephalogram, Epilepsy, Clinical diagnosis

摘要： 目的　比较3D高分辨率磁共振成像（MRI）与视频脑电图（VEEG）临床诊断效果，探究3D高分辨率MRI在癫痫患者临床诊断中的潜在应用价值。方法　回顾性分析聊城市第三人民医院2020年10月至2022年2月间收治的80例疑似癫痫患者资料，其中男46例、女34例，年龄（35.22±7.35）岁。所有患者均行3D高分辨率磁共振成像（MRI）和视频脑电图（VEEG）检查，以术后病理检查为金标准，分析3D高分辨率MRI和VEEG对癫痫病诊断一致性、病灶定位检出率、丘脑患侧和健侧各向异性分数（FA）和平均表现弥散系数（ADC）值大小。计量资料组间比较采用独立样本t检验，计数资料采用χ²检验。结果　80例患者病理检查结果为73例阳性，7例阴性，3D高分辨MRI诊断癫痫准确率为96.25%（77/80），Kappa值为0.78，VEEG诊断癫痫准确率为97.50%（78/80），Kappa值为0.84，二者诊断结果具有较高一致性（Kappa值均>0.75）；3D高分辨MRI检测单侧病灶准确率为96.67%（58/60），双侧病灶为76.92%（10/13），VEEG检测单侧病灶准确率为98.33%（59/60），双侧病灶为92.31%（12/13），两者总检出率比较差异无统计学意义（P>0.05）；单侧受累患者健侧FA值和ADC值均显著小于患侧，差异均有统计学意义（均P<0.05）。结论　3D高分辨MRI对癫痫病具有较高的诊断价值，可清晰显示病灶部位，可用于病情诊断、术前参考和预后分析。

关键词: 3D高分辨率磁共振成像, 视频脑电图, 癫痫, 临床诊断