发作间期脑灌注单光子发射计算机断层扫描在检测癫痫病灶中的价值有限：与氟代脱氧葡萄糖正电子发射断层扫描相比的高分辨率单光子发射计算机断层扫描研究
Limited value of interictal brain perfusion SPECT for detection of epileptic foci: high resolution SPECT studies in comparison with FDG-PET.
作者信息
Nagata T, Tanaka F, Yonekura Y, Ikeda A, Nishizawa S, Ishizu K, Okazawa H, Terada K, Mikuni N, Yamamoto I
机构信息
Department of Radiology, Shiga University of Medical Science, Otsu, Japan.
出版信息
Ann Nucl Med. 1995 May;9(2):59-63. doi: 10.1007/BF03164968.
Accurate localization of epileptic foci is important for pre-surgical evaluation of patients with medically intractable epilepsy, and F-18 FDG PET has been proved to be a valuable method for this purpose. To examine the clinical value with interictal brain perfusion SPECT, we performed brain perfusion SPECT of Tc-99m HMPAO by means of a high resolution SPECT camera, and compared the results with F-18 FDG PET images and MRI in 10 patients with medically intractable epilepsy. In 9 of 10 patients (90%), FDG PET images showed focal hypo-metabolism in the area corresponding with the results of electroencephalography (EEG). SPECT images, however, demonstrated hypo-perfused lesions which corresponded with hypo-metabolic lesions on FDG PET images in only 6 cases (60%). Although MRI showed abnormal findings in 8 cases, the lesions were not directly related to epileptic foci in 2 cases. In conclusion, FDG PET is a valuable tool for accurate localization of epileptic foci. Brain perfusion SPECT, however, may not always be paralleled to metabolism visualized on FDG PET images.
癫痫灶的准确定位对于药物难治性癫痫患者的术前评估至关重要，而F-18 FDG PET已被证明是实现这一目的的一种有价值的方法。为了研究发作间期脑灌注单光子发射计算机断层扫描（SPECT）的临床价值，我们使用高分辨率SPECT相机对10例药物难治性癫痫患者进行了锝-99m六甲基丙烯胺肟（Tc-99m HMPAO）脑灌注SPECT检查，并将结果与F-18 FDG PET图像及磁共振成像（MRI）进行比较。10例患者中有9例（90%），FDG PET图像显示在与脑电图（EEG）结果相对应的区域存在局灶性代谢减低。然而，SPECT图像仅在6例（60%）中显示出与FDG PET图像上代谢减低病灶相对应的灌注减低病灶。虽然MRI在8例中显示出异常发现，但其中2例的病灶与癫痫灶无直接关联。总之，FDG PET是癫痫灶准确定位的一种有价值的工具。然而，脑灌注SPECT并不总是与FDG PET图像上显示的代谢情况相符。
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