대한핵의학회지 (The Korean Journal of Nuclear Medicine)

대한핵의학회 (The Korean Society of Nuclear Medicine)
권호 표지

측두엽 간질에서 발작기 뇌관류 SPECT의 간질병소 국소화 성능

The Performance of Ictal Brain SPECT for Localizing Epileptogenic Foci in Temporal Lobe Epilepsies

  • 김은실 (서울대학교병원 핵의학과) ;
  • 이동수 (서울대학교병원 핵의학과) ;
  • 정준기 (서울대학교병원 핵의학과) ;
  • 이명철 (서울대학교병원 핵의학과) ;
  • 고창순 (서울대학교병원 핵의학과) ;
  • 장기현 (서울대학교병원 진단방사선과) ;
  • 이상건 (서울대학교병원 신경과) ;
  • 정천기 (서울대학교병원 신경외과)
  • Kim, Eun-Sil (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Lee, Dong-Soo (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Chung, June-Key (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Lee, Myung-Chul (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Koh, Chang-Soon (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Chang, Kee-Hyun (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Sang-Kun (Department of Neurology, Seoul National University Hospital) ;
  • Chung, Chun-Kee (Department of Neurosurgery, Seoul National University Hospital)
  • 발행 : 1995.09.25
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초록

Anterior temporal lobectomy has become a widely used resective surgery in patients with medically intractable temporal lobe epilepsies. Prerequisites of this resection include the accurate localization of the epileptogenic focus and the determination that the proposed resection would not result in unacceptable postoperative memory or language deficits. The purpose of this study was to evaluate the performance of ictal SPECT compared to MRI findings for localization of epiletogenic foci in this group of patients. 11 patients who had been anterior temporal lobectomy were evaluated with ictal $^{99m}Tc$-HMPAO SPECT and MRI. MRI showed 8/11(73%) concordant lesion to the side of surgery and ictal SPECT also showed 8/11(73%) concordant hyperperfusion. In 3 cases with incorrect or nonlocalizing findings of MRI, ictal SPECT showed concordant hyperperfusion. In 2 cases confirmed by pre-resectional invasive EEG, MRI showed bilateral and contralateral lesion but ictal SPECT showed concordant hyperperfusion. 3 delayed injection of ictal SPECT showed discordant hyperperfusion. Thus, ictal SPECT was a useful method for localizing epileptogenic foci in temporal lobe epilepsis and appeared complementay to MRI.

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