Leblanc R, Meyer E
Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
J Neurosurg. 1990 Oct;73(4):615-9. doi: 10.3171/jns.1990.73.4.0615.
A case is presented which represents the first instance of the use of functional positron emission tomography (PET) scanning to precisely localize a structural brain lesion to the precentral gyrus, and the first validation of functional PET scanning by intraoperative cortical mapping. The lesion was a 3-cm arteriovenous malformation (AVM) that had produced a generalized seizure in an otherwise asymptomatic young woman. A first, resting H2(15)O PET scan identified the AVM. A second PET scan, performed during vibrotactile stimulation of the contralateral hand, identified the somatosensory area of the hand region and localized the AVM to that part of the precentral gyrus immediately in front of it. This relationship and localization were confirmed by cortical mapping at the time of craniotomy under local anesthesia. Functional PET scanning may prove to be useful to localize cortical lesions precisely and to help in determining preoperatively the best form of treatment for lesions, especially AVM's, in functionally important cortex.
本文报道了一例病例，该病例首次运用功能性正电子发射断层扫描（PET）精确定位脑结构性病变至中央前回，也是术中皮质图谱对功能性PET扫描的首次验证。该病变为一个3厘米的动静脉畸形（AVM），在一名无症状的年轻女性中引发了全身性癫痫发作。首次静息状态下的H2(15)O PET扫描识别出了该AVM。第二次PET扫描是在对侧手部进行振动触觉刺激时进行的，确定了手部区域的体感区，并将AVM定位至其前方紧邻的中央前回部分。这种关系和定位在局部麻醉下开颅手术时通过皮质图谱得到了证实。功能性PET扫描可能被证明有助于精确地定位皮质病变，并有助于在术前确定对位于功能重要皮质区的病变，尤其是AVM的最佳治疗方式。
