Iannetti P, Spalice A, Atzei G, Boemi S, Trasimeni G
Pediatric Department, University La Sapienza, Rome, Italy.
Brain Dev. 1996 Jul-Aug;18(4):269-79. doi: 10.1016/0387-7604(96)00026-5.
Single-photon emission computed tomography (SPECT) is being increasingly used in the investigation of children with epilepsy and may provide insights into congenital malformations. We analyzed the interictal 99Tc-HMPAO-SPECT in a series of seven children with developmental disorders of the neocortex, each of them representing a prototype of cerebral dysgenesis, such as lissencephaly, pachygyria, opercular dysplasia, polymicrogyria, nodular heterotopia and band heterotopia. The patients studied were selected among 22 epileptic children with neuronal migrational disorders (NMDs). Interictal SPECT hypoperfusion was observed in the area homologous to MRI findings in all the examined children. In three patients low perfusion was also present in the opposite hemisphere, probably due to functional involvement or related to an underlying microdysgenesis, not revealed by structural imaging. EEG features were in agreement with low perfusion areas, both anatomically and functionally, in all children. In one patient hypoperfusion area differed from that revealed by MRI and EEG. Ictal SPECT has been considered a useful tool for accurately locating the epileptic focus. Nevertheless, interictal brain perfusion studies, together with proton magnetic resonance spectroscopy, may play an important role in detecting anatomic substrate in developmental disorders of the neocortex.
单光子发射计算机断层扫描（SPECT）越来越多地用于癫痫患儿的检查，并且可能有助于了解先天性畸形。我们分析了一系列7例患有新皮质发育障碍的儿童的发作间期99Tc-HMPAO-SPECT，他们每个人都代表一种脑发育异常的原型，如无脑回畸形、巨脑回畸形、脑岛发育异常、多小脑回畸形、结节性异位和带状异位。研究的患者是从22例患有神经元迁移障碍（NMDs）的癫痫儿童中挑选出来的。在所有接受检查的儿童中，均在与MRI结果相对应的区域观察到发作间期SPECT灌注减低。在3例患者中，对侧半球也存在灌注减低，这可能是由于功能受累或与潜在的微小发育异常有关，而结构成像未显示这种异常。在所有儿童中，脑电图特征在解剖学和功能上均与灌注减低区域相符。在1例患者中，灌注减低区域与MRI和脑电图显示的区域不同。发作期SPECT被认为是准确定位癫痫灶的有用工具。然而，发作间期脑灌注研究与质子磁共振波谱分析一起，可能在检测新皮质发育障碍的解剖学基础方面发挥重要作用。
