Meltzer C C, Adelson P D, Brenner R P, Crumrine P K, Van Cott A, Schiff D P, Townsend D W, Scheuer M L
Department of Radiology, University of Pittsburgh, Pennsylvania, USA.
Epilepsia. 2000 Feb;41(2):193-200. doi: 10.1111/j.1528-1157.2000.tb00139.x.
This work demonstrates the feasibility of planned ictal positron emission tomography (PET) with [18F]fluoro-2-deoxy-glucose (FDG) for localization of epileptic activity in patients with frequent partial seizures of extratemporal origin.
Ictal PET imaging was performed in four patients (two men and two women, ages 28-61) with continuous or very frequent (every 3-15 min) partial seizures. All patients had abnormalities apparent on magnetic resonance (MR) or computed tomographic (CT) imaging, two with extensive brain lesions that precluded precise localization of the seizure focus with interictal PET or single-photon emission tomography (SPECT) imaging.
Ictal PET imaging demonstrated a restricted area of focal hypermetabolism concordant with surface electroencephalographic (EEG) recording in all cases. The PET images were registered to MR imaging data for further anatomic localization of hypermetabolic regions in three cases. The ictal PET data were used to guide neurosurgical intervention in one case.
We conclude that planned ictal PET imaging may be a useful and potentially superior approach to ictal SPECT for identifying the epileptic focus in a selected group of patients with continuous or frequent simple partial seizures.
本研究旨在证明采用[18F]氟代脱氧葡萄糖（FDG）进行计划性发作期正电子发射断层扫描（PET）以定位颞叶外起源的频繁部分性发作患者癫痫活动的可行性。
对4例（2男2女，年龄28 - 61岁）有持续性或非常频繁（每3 - 15分钟发作一次）部分性发作的患者进行发作期PET成像。所有患者在磁共振（MR）或计算机断层扫描（CT）成像上均有明显异常，其中2例有广泛脑病变，使得发作间期PET或单光子发射断层扫描（SPECT）成像无法精确定位癫痫病灶。
在所有病例中，发作期PET成像均显示与表面脑电图（EEG）记录一致的局限性局灶性代谢增高区域。3例患者的PET图像与MR成像数据配准，以进一步对代谢增高区域进行解剖定位。1例患者的发作期PET数据用于指导神经外科干预。
我们得出结论，对于选定的一组有持续性或频繁简单部分性发作的患者，计划性发作期PET成像可能是一种有用且可能优于发作期SPECT的识别癫痫病灶的方法。
