Sasaki M, Kuwabara Y, Yoshida T, Fukumura T, Morioka T, Nishio S, Fukui M, Masuda K
Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
J Nucl Med. 1998 Jun;39(6):974-7.
Focal cortical dysplasia is one of the known neuronal migration disorders and has recently been recognized as a cause of intractable epilepsy. In this study, we assessed the 11C-methionine (MET) uptake in focal cortical dysplasia by PET, and then compared the results with that of 18F-fluoro-2-deoxy-D-glucose (FDG) PET and 99mTc-ethyl cysteinate dimer (ECD) SPECT.
Four patients (3 men, 1 woman; age range 16-68 yr) were examined by PET and SPECT for a presurgical examination of medically intractable seizures. In all 4 patients, 11C-MET PET was performed for 15 min, started 15 min after the administration of 511-662 MBq MET. In 3 of 4 patients, FDG PET was performed for 15 min, and started 20 min after the administration of 185-370 MBq FDG. In all 4 patients, the cerebral blood flow was also evaluated by 99mTc-ECD SPECT for 15 min after the administration of 600 MBq ECD.
In MET PET, all 4 lesions were visually recognized to have high MET uptake areas. The MET uptake of the lesions was 1.44 +/- 0.30 for the standardized uptake value (SUV) (ranging from 0.99-1.61). In FDG PET, 2 lesions were demonstrated to have low uptake areas (3.82 in SUV) while 1 had an ictal high uptake (4.74 in SUV). In ECD SPECT, 1 lesion demonstrated hypoperfusion and 1 ictal hyperperfusion while 2 showed no abnormalities. All 4 patients underwent a cortical resection and the microscopic examinations were consistent with those of focal cortical dysplasia but no evidence of a tumor was found.
MET PET is useful for identifying focal cortical dysplasia as a high uptake area.
局灶性皮质发育不良是一种已知的神经元迁移障碍，最近被认为是难治性癫痫的一个病因。在本研究中，我们通过正电子发射断层扫描（PET）评估了局灶性皮质发育不良中11C-蛋氨酸（MET）的摄取情况，然后将结果与18F-氟-2-脱氧-D-葡萄糖（FDG）PET和99mTc-乙基半胱氨酸二聚体（ECD）单光子发射计算机断层扫描（SPECT）的结果进行比较。
对4例患者（3例男性，1例女性；年龄范围16 - 68岁）进行PET和SPECT检查，用于药物难治性癫痫的术前评估。在所有4例患者中，静脉注射511 - 662 MBq MET后15分钟开始进行11C-MET PET检查，持续15分钟。4例患者中的3例，静脉注射185 - 370 MBq FDG后20分钟开始进行FDG PET检查，持续15分钟。在所有4例患者中，静脉注射600 MBq ECD后进行99mTc-ECD SPECT检查15分钟以评估脑血流量。
在MET PET检查中，所有4个病灶在视觉上均被识别为有高MET摄取区域。病灶的MET摄取标准化摄取值（SUV）为1.44±0.30（范围为0.99 - 1.61）。在FDG PET检查中，2个病灶显示为低摄取区域（SUV为3.82），而1个病灶在发作期有高摄取（SUV为4.74）。在ECD SPECT检查中，1个病灶显示灌注减低，1个病灶在发作期灌注增加，2个病灶无异常。所有4例患者均接受了皮质切除术，显微镜检查结果与局灶性皮质发育不良相符，但未发现肿瘤证据。
MET PET有助于将局灶性皮质发育不良识别为高摄取区域。
