O'Brien T J, Zupanc M L, Mullan B P, O'Connor M K, Brinkmann B H, Cicora K M, So E L
Department of Neurology, The Mayo Clinic and Mayo Medical School, Rochester, Minnesota 55905, USA.
Pediatr Neurol. 1998 Jul;19(1):15-22. doi: 10.1016/s0887-8994(98)00019-8.
Peri-ictal brain single-photon emission computed tomography (SPECT) is increasingly being established as a useful test in localizing partial epilepsy in adults. However, obtaining an ictal injection and acquiring the SPECT images poses a greater challenge in pediatric patients, and few reports have specifically addressed the practical use of this technique in children. The Mayo Clinic experience of peri-ictal SPECT in the evaluation of children with partial epilepsy is reported here. Peri-ictal SPECT was attempted during 71 admissions involving 59 patients (median age 12 years, range 1 year 6 months-17 years). A peri-ictal SPECT injection was performed on 48 (67.6%) of these admissions in 43 (72.9%) patients, and only two patients could not be scanned. Of the 46 peri-ictal images successfully obtained, 30 (65.2%) were from ictal injection and 16 (34.8%) from post-ictal injections. Forty-two (91.3%) of the successfully obtained SPECT images, in 38 patients (92.3%), were classified as localizing (15 temporal, 24 extratemporal). We conclude that, with the appropriate unit setup and well-trained staff, peri-ictal SPECT scans can be obtained in most pediatric partial epilepsy patients. Moreover, the procedure provides specific localizing information in a high proportion of these patients.
发作期脑单光子发射计算机断层扫描（SPECT）越来越被认为是定位成人局灶性癫痫的一项有用检查。然而，在儿科患者中进行发作期注射并获取SPECT图像面临更大挑战，且很少有报告专门探讨该技术在儿童中的实际应用。本文报告了梅奥诊所对发作期SPECT在评估儿童局灶性癫痫中的经验。在涉及59例患者（中位年龄12岁，范围1岁6个月至17岁）的71次住院期间尝试进行发作期SPECT检查。在这些住院患者中，43例（72.9%）的48次（67.6%）住院进行了发作期SPECT注射，只有2例患者未能进行扫描。在成功获得的46幅发作期图像中，30幅（65.2%）来自发作期注射，16幅（34.8%）来自发作后期注射。在38例患者（92.3%）中成功获得的42幅（91.3%）SPECT图像被归类为定位性图像（15例颞叶，24例颞外）。我们得出结论，通过适当的设备设置和训练有素的工作人员，大多数儿科局灶性癫痫患者都可以进行发作期SPECT扫描。此外，该检查在这些患者中很大比例地提供了特定的定位信息。
