Knowlton Robert C
UAB Epilepsy Center, Department of Neurology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
Epilepsy Behav. 2006 Feb;8(1):91-101. doi: 10.1016/j.yebeh.2005.10.015. Epub 2006 Jan 10.
2-[18F]Fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET), ictal single-photon-emission computed tomography (ictal SPECT), and magnetoencephalography (MEG) represent three established functional imaging tests that offer unique information toward the localization of epilepsy for surgery evaluation and treatment. When these tests are combined with high-resolution magnetic fresonance imaging (MRI), epilepsy related structure and function disturbances may be localized with a degree of confidence and understanding not possible with electroencephalography (EEG), even ictal recordings with intracranial electrodes, the mainstay of tools for seizure localization. Use of these alternative tests allows an increased percentage of patients to be considered for surgical treatment. In particular, the additional information provided by these techniques has been demonstrated to help those patients with nonlocalizing MRI or extratemporal lobe epilepsy. Studies that address optimal use of these tests (alone and in combination) will build toward the next major advancement in the surgical treatment of epilepsy by allowing better patient selection, less risk, and better surgical outcomes. Ultimately, appropriate use of these tests, combined with more comprehensive functional brain mapping (e.g., with MEG or functional MRI), may lead to completely noninvasive epilepsy surgery evaluation.
2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描（FDG-PET）、发作期单光子发射计算机断层扫描（发作期SPECT）和脑磁图（MEG）是三种成熟的功能成像检查，可为癫痫手术评估和治疗的定位提供独特信息。当这些检查与高分辨率磁共振成像（MRI）相结合时，癫痫相关的结构和功能障碍的定位可以达到一定的可信度，而这是脑电图（EEG），甚至是颅内电极发作期记录（癫痫发作定位的主要工具）所无法实现的。使用这些替代检查可以使更多患者被考虑进行手术治疗。特别是，这些技术提供的额外信息已被证明有助于那些MRI检查无定位意义或颞叶外癫痫的患者。探讨这些检查（单独使用和联合使用）最佳应用的研究，将通过更好地选择患者、降低风险和改善手术效果，推动癫痫手术治疗的下一个重大进展。最终，合理使用这些检查，并结合更全面的脑功能图谱（如MEG或功能MRI），可能会实现完全无创的癫痫手术评估。
