| 국소성 간질에서 간질병소의 국소화를 위한 SPECT와 PET의 유용성 |
| 김선정, 김상은,홍승봉＊,서대원＊, 홍승철†, 나동규‡, 김병태 |
| 성균관대학교 의과대학 삼성서울병원 핵의학교실, 신경과학교실＊, 신경외과학교실†,
진단방사선과학 교실‡ |
| SPECT and PET for the Localization of Seizure Foci in Localization-Related Epilepsy |
| Sun Jung Kim, M.D., Sang Eun Kim, M.D., Seung Bong Hong, M.D.＊, Dae Won Seo, M.D.＊,
Seung-Chyul Hong, M.D.†, Dong Gyu Na, M.D.‡, Byung-Tae Kim, M.D. |
| Departments of Nuclear Medicine, Neurology*, Neurosurgery†, and Diagnostic Radiology‡,
Sung Kyun Kwan University College of Medicine, Samsung Medical Center, Seoul, Korea |
|
|
|
|
| Abstract |
|
The efficacy of 99mTc-ECD SPECT, [18F]FDG PET, and MRI for the localization of seizure foci was evaluated in 110 patients with partial epilepsy [77 with temporal lobe epilepsy (TLE); 33 with extratemporal lobe epilepsy (ETLE)]. Two standards were employed for the determination of seizure foci: 1) clinico-electrical data and 2) postoperative outcome. In 77 patients with TLE, the sensitivities of interictal and ictal SPECT, [18F]FDG PET, and MRI for the localization of seizure foci were 63%, 90%, 87%, and 80%, respectively. PET localized seizure foci correctly in 75% of TLE patients with normal or nonlocalizing MRI while seizure foci were localized correctly by MRI in 60% of TLE patients with nonlocalizing PET. In 33 TLE patients with good surgical outcome (Engel classes I, II) and greater than one year follow-up, the sensitivities of interictal and ictal SPECT, PET, and MRI were 46%, 100%, 88%, and 82%, respectively. The frequency of extratemporal hypometabolism on preoperative PET was significantly higher in TLE patients with Engel classes IB-IV than in TLE patients with Engel class IA(5/19 vs 14/17, p<0.001). In 33 patients with ETLE, the sensitivities of the neuroimaging studies for the localization of seizure foci were lower: ictal SPECT, 57%; interictal SPECT, 35%; PET, 36%; and MRI, 21%. In 9 ETLE patients with good surgical outcome and greater than one year follow-up, the sensitivities of interictal and ictal SPECT, PET, and MRI were 43%, 50%, 22%, and 33%, respectively. The data demonstrate that ictal perfusion SPECT and [18F]FDG PET may be useful for the localization of seizure foci in TLE. Additionally, the presence of extratemporal hypometabolism in TLE might indicate an unfavorable surgical outcome.
Key Words: epilepsy, single photon emission computed tomography, positron emission tomography |
|
PDF Links
Full text via DOI
Download Citation
