Kim Sunhee, Mountz James M
Division of Nuclear Medicine, Department of Radiology, Children's Hospital of Pittsburgh and The University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Int J Mol Imaging. 2011;2011:813028. doi: 10.1155/2011/813028. Epub 2011 Jul 14.
Epilepsy surgery is highly effective in treating refractory epilepsy, but requires accurate presurgical localization of the epileptogenic focus. Briefly, localization of the region of seizure onset traditionally dependents on seizure semiology, scalp EEG recordings and correlation with anatomical imaging modalities such as MRI. The introduction of noninvasive functional neuroimaging methods, including single-photon emission computed tomography (SPECT) and positron emission tomography (PET) has dramatically changed the method for presurgical epilepsy evaluation. These imaging modalities have become powerful tools for the investigation of brain function and are an essential part of the evaluation of epileptic patients. Of these methods, SPECT has the practical capacity to image blood flow functional changes that occur during seizures in the routine clinical setting. In this review we present the basic principles of epilepsy SPECT and PET imaging. We discuss the properties of the SPECT tracers to be used for this purpose and imaging acquisition protocols as well as the diagnostic performance of SPECT in addition to SPECT image analysis methods. This is followed by a discussion and comparison to F-18 FDG PET acquisition and imaging analysis methods.
癫痫手术在治疗难治性癫痫方面非常有效，但需要在术前准确确定癫痫病灶的位置。简而言之，传统上癫痫发作起始区域的定位依赖于发作症状学、头皮脑电图记录以及与MRI等解剖成像方式的相关性。包括单光子发射计算机断层扫描（SPECT）和正电子发射断层扫描（PET）在内的非侵入性功能神经成像方法的引入，极大地改变了术前癫痫评估的方法。这些成像方式已成为研究脑功能的有力工具，并且是癫痫患者评估的重要组成部分。在这些方法中，SPECT具备在常规临床环境中对癫痫发作期间发生的血流功能变化进行成像的实际能力。在本综述中，我们介绍了癫痫SPECT和PET成像的基本原理。我们讨论了用于此目的的SPECT示踪剂的特性、成像采集方案以及SPECT的诊断性能，此外还介绍了SPECT图像分析方法。随后将对F-18 FDG PET采集和成像分析方法进行讨论和比较。
