Avery R A, Spencer S S, Studholme C, Stokking R, Morano G, Corsi M, Seibyl J P, Spencer D D, Zubal I G
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520-8042, USA.
Eur J Nucl Med. 2000 Jan;27(1):50-5. doi: 10.1007/pl00006662.
Peri-ictal single-photon emission tomography (SPET) difference images co-registered to magnetic resonance imaging (MRI) visualize regional cerebral blood flow (rCBF) changes and help localize the epileptogenic area in medically refractory epilepsy. Few reports have examined the reproducibility of SPET difference image results. Epilepsy patients having two peri-ictal and at least one interictal SPET scan who later underwent surgical resection were studied. Localization accuracy of peri-ictal SPET difference images results, interictal electroencephalography (EEG), and ictal EEG from the first (seizure 1) and second (seizure 2) seizure, as well as MRI and positron emission tomography (PET) findings, were compared using surgical resection site as the standard. Thirteen patients underwent surgical resection (11 temporal lobe and 2 extratemporal). SPET results from seizure 1 were localized to the surgical site in 12/13 (92%) patients, while SPET results from seizure 2 were localized in 13/13 (100%) patients. All other modalities were less accurate than the SPET results interictal EEG--seizure 1 6/13 (46%); ictal EEG--seizure 1 5/13 (38%); interictal intracranial EEG--seizure 2 4/9 (44%); ictal intracranial EEG--seizure 2 results 8/9 (89%); MRI 6/13 (46%); PET 9/13 (69%)[. SPET results were reproducible in 12/13 (92%) patients. SPET difference images calculated from two independent peri-ictal scans appear to be reproducible and accurately localize the epileptogenic area. While SPET difference images visualize many areas of rCBF change, the quantification of these results along with consideration of injection time improves the diagnostic interpretation of the results.
发作期单光子发射断层扫描（SPET）与磁共振成像（MRI）配准的差异图像可显示局部脑血流（rCBF）变化，并有助于在药物难治性癫痫中定位致痫区。很少有报告研究SPET差异图像结果的可重复性。对癫痫患者进行了研究，这些患者有两次发作期及至少一次发作间期SPET扫描，随后接受了手术切除。以手术切除部位为标准，比较了发作期SPET差异图像结果、发作间期脑电图（EEG）以及第一次（发作1）和第二次（发作2）发作的发作期EEG的定位准确性，以及MRI和正电子发射断层扫描（PET）的结果。13例患者接受了手术切除（11例颞叶癫痫和2例颞叶外癫痫）。发作1的SPET结果在12/13（92%）的患者中定位到手术部位，而发作2的SPET结果在13/13（100%）的患者中定位到手术部位。所有其他检查方法的准确性均低于SPET结果——发作间期EEG——发作1为6/13（46%）；发作期EEG——发作1为5/13（38%）；发作间期颅内EEG——发作2为4/9（44%）；发作期颅内EEG——发作2结果为8/9（89%）；MRI为6/13（46%）；PET为9/13（69%）。SPET结果在12/13（92%）的患者中具有可重复性。由两次独立的发作期扫描计算出的SPET差异图像似乎具有可重复性，并能准确地定位致痫区。虽然SPET差异图像可显示rCBF变化的许多区域，但对这些结果进行量化并考虑注射时间可改善结果的诊断解读。
