Matsuda H, Fukuchi T, Onuma T, Ishida S, Uesugi H
Division of Radiology, National Center Hospital for Mental, Nervous, and Muscular Disorders, NCNP, Tokyo, Japan.
Clin Nucl Med. 1996 Nov;21(11):867-72. doi: 10.1097/00003072-199611000-00009.
The usefulness of noninvasive regional cerebral blood flow measurements using Tc-99m hexamethylpropylene amine oxime (HMPAO) was evaluated in 45 patients with interictal temporal lobe epilepsy. Seizure frequency did not show any influence on flow values or side-to-side asymmetry. Patients taking phenytoin had a significantly lower mean cerebral blood flow (mean 9.5%) and lower mean cerebellar blood flow (mean 12.9%) than those not taking it. Moreover, phenytoin reduced regional cerebral blood flow in the temporal regions more prominently on the contralateral side of the epileptic focus than on the ipsilateral side. Positive MRI findings of hippocampal sclerosis along with visually detected temporal hypoperfusion on SPECT showed a lower regional cerebral blood flow and greater flow asymmetry than other imaging findings in the temporal region. Results suggest that noninvasive cerebral blood flow measurements using Tc-99m HMPAO may give useful information about interictal cerebral blood flow around an epileptic focus and about the effects of antiepileptic drugs on brain function in temporal lobe epilepsy.
使用锝-99m六甲基丙烯胺肟（HMPAO）进行无创性局部脑血流测量在45例发作间期颞叶癫痫患者中的实用性得到了评估。癫痫发作频率对血流值或双侧不对称性未显示出任何影响。服用苯妥英钠的患者平均脑血流量（平均9.5%）和平均小脑血流量（平均12.9%）显著低于未服用者。此外，苯妥英钠对癫痫灶对侧颞区局部脑血流量的降低作用比对侧更显著。海马硬化的MRI阳性结果以及SPECT上视觉检测到的颞叶灌注不足显示，与颞区的其他影像学结果相比，其局部脑血流量更低且血流不对称性更大。结果表明，使用锝-99m HMPAO进行无创性脑血流测量可能会提供有关癫痫灶周围发作间期脑血流以及抗癫痫药物对颞叶癫痫脑功能影响的有用信息。
