The role of SISCOM in preoperative evaluation for patients with epilepsy surgery: A meta-analysis
The role of SISCOM in preoperative evaluation for patients with epilepsy surgery: A meta-analysis
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DOI：
10.1016/j.seizure.2016.06.024
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发表时间：
2016-10-01
影响因子：
3
通讯作者：
Guo, Liang
中科院分区：
文献类型：
--
作者：
Chen, Tong;Guo, Liang
目的：为评价发作期和发作间期减影SPELT与MRI联合配准（SISCOM）在识别致痫灶（EZ）和预测癫痫手术患者术后结局中的特异性价值，对1995年1月至2015年6月发表的11篇文献进行了荟萃分析。首先使用R软件计算合并阳性率、一致率和良好结局的阳性预测值（PPV）。结果：SISCOM定位的未加权阳性率和符合率分别为85.9%和65.3%。142例MRI阴性患者中，SISCOM阳性率为83.8%。178例SISCOM一致的手术患者的合并PPV为56%。在275例手术患者的荟萃分析中，一致性SISCOM患者的无并发症比值比是不一致性SISCOM患者的3.28倍[95%CI（1.90，5.67）]。对于颞叶外癫痫，一致性SISCOM患者的无癫痫风险比值比是不一致性SISCOM患者的2.44倍[95%CI（1.34，4.43）]。结论：我们的数据表明，SISCOM在定位致痫灶方面具有中等敏感性，并且在MRI阴性时可以提供补充信息。此外，与金标准一致的SISCOM定位显示出对良好手术结局的预测价值略高。SISCOM定位结果对颞叶与颞叶外癫痫的影响有待进一步研究。(C)2016年英国癫痫协会。由爱思唯尔有限公司出版。保留所有权利。
Purpose: To assess the specific value of subtraction ictal and inter-ictal SPELT co-registered to MRI (SISCOM) in identifying the epileptogenic zone (EZ) and predicting postoperative outcomes in epileptic surgical patients.Method: A meta-analysis of studies published from January 1995 to June 2015 was conducted through a comprehensive literature search, and 11 studies were included. R software was first used to calculate a pooled positive rate, concordant rate and positive predictive value (PPV) for good outcomes. Stata software was then used to explore the relationship between SISCOM localization and surgical outcomes, including a subgroup analysis for extra-temporal lobe epilepsy.Results: The unweighted positive and concordant rates of SISCOM were 85.9% and 65.3%, respectively. In 142 MRI-negative patients, the SISCOM positive rate was 83.8%. The pooled PPV of 178 surgical patients with concordant SISCOM was 56%. In the meta-analysis of 275 surgical patients, the seizure-free odds ratio was 3.28-times higher in concordant than in non-concordant SISCOM patients [95%CI (1.90, 5.67)]. For extra-temporal lobe epilepsy, the seizure-free odds ratio was 2.44-times higher in concordant than in non-concordant SISCOM patients [95%CI (1.34, 4.43)].Conclusion: Our data indicate that SISCOM has moderate sensitivity in localizing the epileptogenic zone and can provide complementary information when MRI is negative. Furthermore, SISCOM localization concordant with the gold standard demonstrates slightly higher predictive value for good surgical outcomes. Further research is required to explore the influence of SISCOM localization results in temporal lobe versus extra-temporal lobe epilepsy. (C) 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.