Grünwald F, Menzel C, Pavics L, Bauer J, Hufnagel A, Reichmann K, Sakowski R, Elger C E, Biersack H J
Department of Nuclear Medicine, University of Bonn, Germany.
J Nucl Med. 1994 Dec;35(12):1896-901.
The aim of this study was to evaluate the use of 99mTc-ethyl cysteinate dimer (ECD), also known as 99mTc-bicisate, in the presurgical evaluation of patients suffering from medically intractable epilepsy.
Twenty-three brain SPECT studies (8 ictally and 15 interictally) were performed on 16 patients with a high-resolution annular SPECT system (CERASPECT). For the ictal studies, the tracer was injected in the very early phase of the seizure. The delay between seizure onset and 99mTc-ECD injection was 2-20 sec.
Interictally, all patients showed circumscribed hypoperfusions. In four patients, the SPECT lesion represented only structural defects. Circumscribed increased tracer uptake was observed in all ictal studies. For all patients with temporal lobe epilepsy without significant mass lesion, in whom an interictal and ictal 99mTc-ECD-SPECT study could be obtained, the asymmetry index was 0.88 +/- 0.03 for the interictal and 1.23 +/- 0.08 for the ictal studies.
The data suggest that 99mTc-ECD is an effective marker of cerebral perfusion imaging in epilepsy. In comparison to other tracers, it has a high in vitro stability and is therefore particularly useful for ictal studies in the very early phase after seizure onset.
本研究的目的是评估99mTc-半胱氨酸乙酯二聚体（ECD），即99mTc-比西酯，在药物难治性癫痫患者术前评估中的应用。
对16例患者使用高分辨率环形单光子发射计算机断层扫描系统（CERASPECT）进行了23次脑单光子发射计算机断层扫描研究（8次发作期和15次发作间期）。对于发作期研究，在癫痫发作的极早期注射示踪剂。癫痫发作开始至99mTc-ECD注射的延迟时间为2 - 20秒。
在发作间期，所有患者均显示局限性灌注减低。4例患者中，单光子发射计算机断层扫描病变仅代表结构缺陷。在所有发作期研究中均观察到局限性示踪剂摄取增加。对于所有无明显占位性病变的颞叶癫痫患者，若能获得发作间期和发作期99mTc-ECD单光子发射计算机断层扫描研究结果，发作间期的不对称指数为0.88±0.03，发作期为1.23±0.08。
数据表明99mTc-ECD是癫痫脑灌注成像的有效标志物。与其他示踪剂相比，它具有较高的体外稳定性，因此特别适用于癫痫发作开始后极早期的发作期研究。
