Carvalho Marcela Santos, Alvim Marina Koutsodontis Machado, Etchebehere Elba, Santos Allan de Oliveira, Ramos Celso Dario, Argenton Juliana Luz Passos, Cendes Fernando, Amorim Bárbara Juarez
Medicina Nuclear Diagnóstico (MND), Campinas, SP, Brazil.
Departamento de Neurologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil.
Radiol Bras. 2022 Sep-Oct;55(5):273-279. doi: 10.1590/0100-3984.2021.0141.
To evaluate the performance of F-fluorodeoxyglucose positron-emission tomography/computed tomography ( F-FDG PET/CT) in localizing epileptogenic zones, comparing F-FDG injection performed in the traditional interictal period with that performed near the time of a seizure.
We evaluated patients with refractory epilepsy who underwent F-FDG PET/CT. The reference standards for localization of the epileptogenic zone were histopathology and follow-up examinations (in patients who underwent surgery) or serial electroencephalography (EEG) recordings, long-term video EEG, and magnetic resonance imaging (in patients who did not). The F-FDG injection was performed whether the patient had an epileptic seizure during the EEG monitoring period or not. The F-FDG PET/CT results were categorized as concordant or discordant with the reference standards.
Of the 110 patients evaluated, 10 were in a postictal group (FDG injection after a seizure) and 100 were in the interictal group. The F-FDG PET/CT was concordant with the reference standards in nine (90%) of the postictal group patients and in 60 (60%) of the interictal group patients. Among the nine postictal group patients in whom the results were concordant, the F-FDG PET/CT showed hypermetabolism and hypometabolism in the epileptogenic zone in four (44.4%) and five (55.6%), respectively.
Our data indicate that F-FDG PET/CT is a helpful tool for localization of the epileptogenic zone and that EEG monitoring is an important means of correlating the findings. In addition, postictal F-FDG PET/CT is able to identify the epileptogenic zone by showing either hypometabolism or hypermetabolism.
评估氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）在定位癫痫病灶区方面的性能，比较在传统发作间期进行F-FDG注射与在癫痫发作临近时进行F-FDG注射的情况。
我们评估了接受F-FDG PET/CT检查的难治性癫痫患者。癫痫病灶区定位的参考标准为组织病理学和随访检查（接受手术的患者）或系列脑电图（EEG）记录、长期视频脑电图以及磁共振成像（未接受手术的患者）。无论患者在EEG监测期间是否发生癫痫发作，均进行F-FDG注射。F-FDG PET/CT结果分为与参考标准一致或不一致。
在评估的110例患者中，10例为发作后期组（发作后进行FDG注射），100例为发作间期组。F-FDG PET/CT在发作后期组9例（90%）患者和发作间期组60例（60%）患者中与参考标准一致。在结果一致的9例发作后期组患者中，F-FDG PET/CT在癫痫病灶区分别显示4例（44.4%）代谢增高和5例（55.6%）代谢减低。
我们的数据表明，F-FDG PET/CT是定位癫痫病灶区的有用工具，EEG监测是关联检查结果的重要手段。此外，发作后F-FDG PET/CT能够通过显示代谢减低或代谢增高来识别癫痫病灶区。
