使用(11)C-蛋氨酸正电子发射断层扫描/计算机断层扫描评估颞叶癫痫合并杏仁核增大患者的杏仁核病理学
Evaluation of amygdala pathology using (11)C-methionine positron emission tomography/computed tomography in patients with temporal lobe epilepsy and amygdala enlargement.
作者信息
Sone Daichi, Ito Kimiteru, Taniguchi Go, Murata Yoshiko, Nakata Yasuhiro, Watanabe Yutaka, Okazaki Mitsutoshi, Sato Noriko, Matsuda Hiroshi, Watanabe Masako
机构信息
Department of Radiology, National Center of Neurology and Psychiatry, Japan; Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Japan.
Department of Radiology, National Center of Neurology and Psychiatry, Japan.
出版信息
Epilepsy Res. 2015 May;112:114-21. doi: 10.1016/j.eplepsyres.2015.02.018. Epub 2015 Mar 10.
OBJECTIVE
The association between amygdala enlargement (AE) and temporal lobe epilepsy (TLE) has increasingly been reported. However, the pathology of AE remains poorly understood. The purpose of this study was to explore AE pathology using (11)C-methionine (Met) positron emission tomography (PET)/computed tomography (CT) in patients who have TLE with AE.
MATERIALS AND METHODS
Twenty-six TLE patients with AE and 18 TLE patients without AE underwent (11)C-Met PET/CT and magnetic resonance imaging (MRI). (11)C-Met uptake in amygdala was evaluated by both visual inspection and semi-quantitative measurement. MRI was assessed visually and semi-quantitatively for AE. Laterality index (LI) was obtained by comparing the amygdala volumes of ipsilateral and contralateral sides. The clinical course and histopathological findings of all patients were also analyzed.
RESULTS
On (11)C-Met PET/CT images, visual examination detected increased uptake in the enlarged amygdala in 7 of 26 (27%) TLE patients with AE, and the results were confirmed by semi-quantitative analysis. Among six TLE patients with AE who underwent surgery, histopathology revealed neoplasms (low grade astrocytoma and gangliocytoma) in two patients and focal cortical dysplasia in one patient with increased (11)C-Met uptake, but non-neoplastic lesions (focal cortical dysplasia, vacuolar degeneration, and hamartoma) in all three patients with no increased (11)C-Met uptake. On MRI, volume of the affected amygdala was significantly larger compared to the contralateral amygdala. LI was significantly higher in the group with AE than in the group without AE.
CONCLUSIONS
This study revealed that some TLE patients with AE showed increased (11)C-Met uptake in the enlarged amygdala. (11)C-Met PET/CT is potentially useful for the evaluation of AE pathology, and may provide beneficial information for appropriate decision-making.
目的
杏仁核增大（AE）与颞叶癫痫（TLE）之间的关联已有越来越多的报道。然而，AE的病理学仍知之甚少。本研究的目的是利用（11）C-蛋氨酸（Met）正电子发射断层扫描（PET）/计算机断层扫描（CT）对患有AE的TLE患者进行AE病理学探索。
材料与方法
26例伴有AE的TLE患者和18例不伴有AE的TLE患者接受了（11）C-Met PET/CT和磁共振成像（MRI）检查。通过视觉检查和半定量测量评估杏仁核中（11）C-Met的摄取情况。对MRI进行视觉和半定量评估以确定AE情况。通过比较同侧和对侧杏仁核的体积获得偏侧性指数（LI）。还分析了所有患者的临床病程和组织病理学结果。
结果
在（11）C-Met PET/CT图像上，视觉检查在26例伴有AE的TLE患者中的7例（27%）增大的杏仁核中检测到摄取增加，半定量分析证实了该结果。在6例接受手术的伴有AE的TLE患者中，组织病理学显示，在摄取增加的2例患者中发现肿瘤（低级别星形细胞瘤和神经节细胞瘤），1例患者发现局灶性皮质发育不良，但在摄取未增加的3例患者中均发现非肿瘤性病变（局灶性皮质发育不良、空泡变性和错构瘤）。在MRI上，患侧杏仁核的体积明显大于对侧杏仁核。伴有AE的组的LI显著高于不伴有AE的组。
结论
本研究表明，一些伴有AE的TLE患者增大的杏仁核中（11）C-Met摄取增加。（11）C-Met PET/CT对AE病理学评估可能有用，并可能为恰当的决策提供有益信息。
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