Abstract：
In patients with drug-resistant epilepsy, difficulties in identifying the epileptogenic zone are well known to correlate with poorer clinical outcomes post-surgery. The integration of PET and MRI in the presurgical assessment of pediatric patients likely improves diagnostic precision by confirming or widening treatment targets. PET and MRI together offer superior insights compared to either modality alone. For instance, PET highlights abnormal glucose metabolism, while MRI precisely localizes structural anomalies, providing a comprehensive understanding of the epileptogenic zone. Furthermore, both methodologies, whether utilized through simultaneous PET/MRI scanning or the co-registration of separately acquired PET and MRI data, present unique advantages, having complementary roles in lesional and non-lesional cases. Simultaneous FDG-PET/MRI provides precise co-registration of functional (PET) and structural (MR) imaging in a convenient one-stop-shop approach, which minimizes sedation time and reduces radiation exposure in children. Commercially available fusion software that allows retrospective co-registration of separately acquired PET and MRI images is a commonly used alternative. This review provides an overview and illustrative cases that highlight the role of combining 18F-FDG-PET and MRI imaging and shares the authors\' decade-long experience utilizing simultaneous PET/MRI in the presurgical evaluation of pediatric epilepsy.
摘要：
在耐药癫痫患者中，众所周知,确定癫痫发生区的困难与术后较差的临床结局相关.PET和MRI在儿科患者的术前评估中的整合可能通过确认或扩大治疗目标来提高诊断精度。与单独的任何一种方式相比，PET和MRI一起提供了优越的见解。例如,PET突出葡萄糖代谢异常，而MRI精确定位结构异常，提供对癫痫发生区的全面了解。此外，两种方法，无论是通过同步PET/MRI扫描还是单独采集的PET和MRI数据的共同配准，呈现出独特的优势，在病变和非病变病例中具有互补作用。同时FDG-PET/MRI以便捷的一站式方法提供功能（PET）和结构（MR）成像的精确配准，最大限度地减少镇静时间，减少儿童的辐射暴露。允许对单独采集的PET和MRI图像进行回顾性配准的市售融合软件是常用的替代方案。这篇综述提供了概述和说明性案例，突出了18F-FDG-PET和MRI成像的结合作用，并分享了作者十年来在小儿癫痫的术前评估中同时使用PET/MRI的经验。
