Takano A, Shiga T, Kobayashi J, Adachi I, Nakamura F, Koyama T, Katoh C, Morita K, Tsukamoto E, Tamaki N
Department of Nuclear Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Nucl Med Commun. 2001 Mar;22(3):319-24. doi: 10.1097/00006231-200103000-00009.
Interictal brain single photon emission computed tomography (SPECT) is useful for the detection of seizure focus. Recent reports indicate a hypoperfusion in the ipsilateral thalamus as a seizure focus on interictal SPECT in temporal lobe epilepsy. In frontal lobe epilepsy (FLE), however, the alteration of perfusion in the thalamus has not been well documented. This study aimed to assess whether perfusion analysis on the thalamus may add useful information for the detection of epileptic foci in patients with FLE.
Interictal brain SPECT was performed in 11 patients with FLE. The asymmetry index for the thalamus and frontal area in the SPECT image was calculated in order to compare the laterality of the seizure foci.
Thalamic asymmetry was seen in seven patients (64%), while cortial asymmetry was seen in six patients (55%). The concordance with the lateralization of the seizure foci was 6/7 (86%) in the thalamus, and 4/6 (67%) in the frontal area. Four patients showed only thalamic asymmetry. Concordance with the lateralization of the seizure focus was found in all of them.
These preliminary results suggest that hypoperfusion in the thalamus may have a complementary role to lateralize the epileptic foci in patients with FLE.
发作间期脑单光子发射计算机断层扫描（SPECT）有助于检测癫痫病灶。最近的报告表明，在颞叶癫痫的发作间期SPECT上，同侧丘脑存在灌注不足，作为癫痫病灶。然而，在额叶癫痫（FLE）中，丘脑灌注的改变尚未得到充分记录。本研究旨在评估对丘脑的灌注分析是否可为FLE患者癫痫病灶的检测增加有用信息。
对11例FLE患者进行发作间期脑SPECT检查。计算SPECT图像中丘脑和额叶区域的不对称指数，以比较癫痫病灶的侧别。
7例患者（64%）出现丘脑不对称，6例患者（55%）出现皮质不对称。丘脑与癫痫病灶侧别的一致性为6/7（86%），额叶区域为4/6（67%）。4例患者仅表现为丘脑不对称。在所有这些患者中均发现与癫痫病灶侧别的一致性。
这些初步结果表明，丘脑灌注不足可能对FLE患者癫痫病灶的侧别定位具有补充作用。
