Grünwald F, Durwen H F, Bockisch A, Hotze A, Kersjes W, Elger C E, Biersack H J
Department of Nuclear Medicine, University of Bonn, Federal Republic of Germany.
J Nucl Med. 1991 Mar;32(3):388-94.
The aim of the present study was to evaluate the predictive value of interictal single-photon emission computed tomography (SPECT) using technetium-99m-labeled hexamethyl propyleneamine oxime (HMPAO) for the outcome after temporal lobectomy in patients with complex partial seizures. Out of 40 patients, 21 underwent right-sided and 19 left-sided temporal lobectomy. EEG and CT/MRI were primarily used to select the side of surgery. SPECT results correlated with temporal lobectomy in 68% of the patients. After surgical intervention, memory function was tested for both sides. Following left-sided temporal lobectomy, verbal memory was impaired in 8% of the patients, if SPECT agreed with the side selected for surgery, but in 83%, if it diverged from it. In the present study, there was no relationship between SPECT concordance with the side of temporal lobectomy and outcome as to seizure frequency and non-verbal memory. We conclude that preoperative interictal HMPAO/SPECT can contribute to the prediction of postoperative verbal memory function and that this method should be considered for use prior to temporal lobectomy.
本研究的目的是评估使用锝-99m标记的六甲基丙烯胺肟（HMPAO）进行发作间期单光子发射计算机断层扫描（SPECT）对复杂部分性发作患者颞叶切除术后预后的预测价值。40例患者中，21例行右侧颞叶切除术，19例行左侧颞叶切除术。脑电图和CT/MRI主要用于选择手术侧。68%的患者SPECT结果与颞叶切除术相关。手术干预后，对双侧记忆功能进行测试。左侧颞叶切除术后，如果SPECT结果与所选手术侧一致，8%的患者出现言语记忆受损；如果不一致，则83%的患者出现言语记忆受损。在本研究中，SPECT与颞叶切除侧的一致性与癫痫发作频率和非言语记忆的预后之间没有关系。我们得出结论，术前发作间期HMPAO/SPECT有助于预测术后言语记忆功能，并且在颞叶切除术之前应考虑使用这种方法。
