Mitsuyoshi I, Tamaki K, Okuno T, Mutoh K, Iwasaki Y, Konishi J, Mikawa H
Department of Pediatrics, Faculty of Medicine, Kyoto University, Japan.
Brain Dev. 1993 Mar-Apr;15(2):97-102. doi: 10.1016/0387-7604(93)90044-9.
We compared regional cerebral blood flow assessed by [123I]N-isopropyl-p-iodoamphetamine (IMP) single-photon emission tomography (SPECT) with magnetic resonance imaging (MRI), computed tomography (CT) and interictal surface electroencephalography (EEG) to evaluate its diagnostic potential in 24 patients with partial seizures with onset in childhood. Focal low uptake areas were observed on SPECT scans of 18 patients and were presumed to represent epileptogenic areas in 17. MRI revealed an abnormality in 12 and CT in 6 patients, and all organic lesions showed SPECT abnormalities, too. Six patients without focal structural abnormalities showed regional perfusion deficit on SPECT. Routine scalp EEG revealed an epileptic focus in 17 patients and three of them showed discordant results between SPECT and EEG, which suggested more serious brain disorders. In two patients without EEG localization only SPECT showed focal abnormalities in the probable epileptic area. [123I]IMP-SPECT was useful in locating the epileptic focus, particularly during the early period after the onset of partial seizures when the EEG gave inconclusive results.
我们将通过[123I]N-异丙基-p-碘安非他明（IMP）单光子发射断层扫描（SPECT）评估的局部脑血流量与磁共振成像（MRI）、计算机断层扫描（CT）和发作间期头皮脑电图（EEG）进行比较，以评估其对24例儿童期起病的部分性癫痫患者的诊断潜力。18例患者的SPECT扫描显示有局灶性低摄取区域，其中17例被推测为致痫区。MRI显示12例患者有异常，CT显示6例患者有异常，所有器质性病变的SPECT也均有异常。6例无局灶性结构异常的患者SPECT显示局部灌注不足。常规头皮脑电图显示17例患者有癫痫病灶，其中3例SPECT和脑电图结果不一致，提示脑部疾病更严重。在2例脑电图无定位的患者中，仅SPECT在可能的癫痫区域显示局灶性异常。[123I]IMP-SPECT有助于癫痫病灶的定位，尤其是在部分性癫痫发作早期脑电图结果不明确时。
