Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Mol Imaging. 2021 Mar 2;2021:6614356. doi: 10.1155/2021/6614356. eCollection 2021.
Up to 30% of patients with epilepsy may not respond to antiepileptic drugs. Patients with drug-resistant epilepsy (DRE) should undergo evaluation for seizure onset zone (SOZ) localization to consider surgical treatment. Cases of drug-resistant nonlesional extratemporal lobe epilepsy (ETLE) pose the biggest challenge in localizing the SOZ and require multiple noninvasive diagnostic investigations before planning the intracranial monitoring (ICM) or direct resection. Ictal Single Photon Emission Computed Tomography (i-SPECT) is a unique functional diagnostic tool that assesses the SOZ using the localized hyperperfusion that occurs early in the seizure. Subtraction ictal SPECT coregistered to MRI (SISCOM), statistical ictal SPECT coregistered to MRI (STATISCOM), and PET interictal subtracted ictal SPECT coregistered with MRI (PISCOM) are innovative SPECT methods for the determination of the SOZ. This article comprehensively reviews SPECT and sheds light on its vital role in the presurgical evaluation of the nonlesional extratemporal DRE.
多达 30%的癫痫患者可能对抗癫痫药物没有反应。耐药性癫痫（DRE）患者应进行发作起始区（SOZ）定位评估，以考虑手术治疗。耐药性非病变性颞叶外癫痫（ETLE）的病例在定位 SOZ 方面构成最大挑战，需要进行多次非侵入性诊断研究，然后再计划进行颅内监测（ICM）或直接切除。发作期单光子发射计算机断层扫描（i-SPECT）是一种独特的功能诊断工具，它使用在癫痫发作早期发生的局部高灌注来评估 SOZ。减去发作期 SPECT 与 MRI 配准（SISCOM）、统计发作期 SPECT 与 MRI 配准（STATISCOM）和 PET 发作间期减去发作期 SPECT 与 MRI 配准（PISCOM）是用于确定 SOZ 的创新 SPECT 方法。本文全面回顾了 SPECT，并阐明了其在非病变性颞叶外 DRE 术前评估中的重要作用。
