Lamusuo S, Ruottinen H M, Knuuti J, Härkönen R, Ruotsalainen U, Bergman J, Haaparanta M, Solin O, Mervaala E, Nousiainen U, Jääskeläinen S, Ylinen A, Kälviäinen R, Rinne J K, Vapalahti M, Rinne J O
Department of Neurology, University of Turku, Finland.
J Neurol Neurosurg Psychiatry. 1997 Dec;63(6):743-8. doi: 10.1136/jnnp.63.6.743.
Firstly, to compare the findings of interictal 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and of single photon emission computed tomography (SPECT) using 99mTc-hexamethyl propylene-amine-oxime (HMPAO) and 123I-iomazenil in localising the epileptogenic cortex in patients who were candidates for epilepsy surgery, but in whom clinical findings, video EEG monitoring (V-EEG), MRI, and neuropsychological evaluations did not give any definite localisation of the seizure onset. Secondly, to assess the ability of these functional methods to help in the decision about the epilepsy surgery.
Eighteen epileptic patients were studied with FDG-PET and iomazenil-SPECT. HMPAO-SPECT was performed in 11 of these 18 patients. Two references for localisation was used--ictal subdural EEG recordings (S-EEG) and the operated region.
Fifteen of 18 patients had localising findings in S-EEG. FDG-PET findings were in accordance with the references in 13 patients and iomazenil-SPECT in nine patients. HMPAO-SPECT visualised the focus less accurately than the two other methods. In three patients S-EEG showed independent bitemporal seizure onset. In these patients FDG-PET showed no lateralisation. However, iomazenil-SPECT showed temporal lobe lateralisation in two of them.
FDG-PET seemed to localise the epileptogenic cortex more accurately than interictal iomazenil-SPECT in patients with complicated focal epilepsy.
第一，比较发作间期18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）以及使用99mTc-六甲基丙烯胺肟（HMPAO）和123I-碘美西尼的单光子发射计算机断层扫描（SPECT）在确定癫痫手术候选患者致痫皮层位置方面的结果，这些患者的临床症状、视频脑电图监测（V-EEG）、磁共振成像（MRI）和神经心理学评估均未明确癫痫发作起始部位。第二，评估这些功能检查方法在辅助癫痫手术决策方面的能力。
对18例癫痫患者进行FDG-PET和碘美西尼-SPECT检查。其中11例患者还进行了HMPAO-SPECT检查。采用两个定位参考标准——发作期硬膜下脑电图记录（S-EEG）和手术区域。
18例患者中有15例在S-EEG检查中有定位结果。FDG-PET检查结果与参考标准相符的有13例患者，碘美西尼-SPECT检查结果与之相符的有9例患者。HMPAO-SPECT对病灶的显示不如其他两种方法准确。3例患者S-EEG显示独立的双侧颞叶癫痫发作起始。在这些患者中，FDG-PET未显示出偏侧化。然而，碘美西尼-SPECT在其中2例患者中显示出颞叶偏侧化。
在复杂局灶性癫痫患者中，FDG-PET似乎比发作间期碘美西尼-SPECT能更准确地定位致痫皮层。
