Newton M R, Berkovic S F, Austin M C, Rowe C C, McKay W J, Bladin P F
Department of Neurology, Austin Hospital, Melbourne, Victoria, Australia.
Eur J Nucl Med. 1994 Oct;21(10):1067-71. doi: 10.1007/BF00181061.
Single-photon emission tomography (SPET) using radioligands that are fixed on first pass through the cerebral circulation shows distinctive and rapidly changing blood flow patterns accompanying temporal lobe seizures. We sought to determine the optimal time to perform SPET studies for clinical seizure lateralization in temporal lobe epilepsy. Interictal, ictal and postictal SPET scans of 73 consecutively studied patients with unilateral temporal lobe epilepsy were read by three blinded observers to assess the accuracy of lateralization in each condition. The blinded observers correctly identified the side of focus in 97% of ictal studies, 72% of postictal studies and 50% of interictal studies. No incorrect scores were made in the ictal studies, whilst 5% of postictal and 12% of interictal studies were lateralized to the wrong side. Inter-observer agreement was best with the ictal studies. The dramatic perfusion changes of ictal SPET provide consistent, reliable and easily interpretable information that is superior to that provided by interictal and postictal studies. Injection of ligand during seizures is therefore the method of choice for SPET to aid the non-invasive lateralization of temporal seizure foci.
使用在首次通过脑循环时就固定的放射性配体的单光子发射断层扫描（SPET）显示，颞叶癫痫发作时伴随着独特且快速变化的血流模式。我们试图确定在颞叶癫痫中进行SPET研究以实现临床发作侧化的最佳时间。由三位不知情的观察者对73例连续研究的单侧颞叶癫痫患者进行发作间期、发作期和发作后期的SPET扫描，以评估每种情况下侧化的准确性。不知情的观察者在97%的发作期研究、72%的发作后期研究和50%的发作间期研究中正确识别出病灶侧。在发作期研究中没有出现错误评分，而在发作后期研究中有5%、发作间期研究中有12%被侧化到错误的一侧。观察者间一致性在发作期研究中最佳。发作期SPET的显著灌注变化提供了一致、可靠且易于解释的信息，优于发作间期和发作后期研究提供的信息。因此，在癫痫发作期间注射配体是SPET辅助颞叶癫痫病灶非侵入性侧化的首选方法。
