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Titolo:
ICTAL AND INTERICTAL TECHNETIUM-99M-BICISATE BRAIN SPECT IN CHILDREN WITH REFRACTORY EPILEPSY
Autore:
PACKARD AB; ROACH PJ; DAVIS RT; CARMANT L; DAVIS R; RIVIELLO J; HOLMES G; BARNES PD; OTUAMA LA; BJORNSON B; TREVES ST;
Indirizzi:
HARVARD UNIV,CHILDRENS HOSP,SCH MED,DIV NUCL MED,300 LONGWOOD AVE BOSTON MA 02115 HARVARD UNIV,CHILDRENS HOSP,SCH MED,DEPT NEUROL BOSTON MA 02115 HARVARD UNIV,CHILDRENS HOSP,SCH MED,DEPT RADIOL BOSTON MA 02115
Titolo Testata:
The Journal of nuclear medicine
fascicolo: 7, volume: 37, anno: 1996,
pagine: 1101 - 1106
SICI:
0161-5505(1996)37:7<1101:IAITBS>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
EMISSION COMPUTED-TOMOGRAPHY; LOBE EPILEPSY; LOCALIZATION; SEIZURES; PET;
Keywords:
TECHNETIUM-99M-BICISATE; EPILEPSY; SPECT; PEDIATRICS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
A.B. Packard et al., "ICTAL AND INTERICTAL TECHNETIUM-99M-BICISATE BRAIN SPECT IN CHILDREN WITH REFRACTORY EPILEPSY", The Journal of nuclear medicine, 37(7), 1996, pp. 1101-1106

Abstract

Identification of epileptogenic foci in patients with refractory epilepsy remains a significant diagnostic challenge. Magnetic resonance imaging studies frequently fail to reveal an anatomic origin for the seizures, and scalp electroencephalography is often limited to identification of the involved hemisphere. Functional imaging modalities such asPET and SPECT are more promising tools for this application because they reflect the functional pathology associated with the seizure. These changes are more pronounced ictally, but until recently, no radiopharmaceutical was available that could be used routinely for ictal SPECT. The present study was therefore undertaken to determine whether Tc-99m-bicisate could be used in ictal SPECT in pediatric patients with refractory epilepsy, to compare the patterns of ictal and interictal blood flow in these patients and to compare the localization information provided by ictal SPECT with that available from other techniques. Methods: Technetium-99m-bicisate/SPECT was compared prospectively with scalp EEG for its ability to identify a possible seizure focus in pediatric patients with refractory epilepsy. Ictal and interictal SPECT studies were performed in 10 patients (3-19 yr old, mean age 10.9 +/- 4.3 yr; 7 female, 3 male) in whom MRI scans revealed no lesions that mightbe responsible for the seizures. Results: Ictal SPECT was performed in all patients, and all ictal studies revealed focal perfusion abnormalities. By comparison, four of the interictal SPECT studies showed regional hypoperfusion that corresponded to the regions of hyperperfusionin the ictal studies, and three showed regional hyperperfusion corresponding to the hyperperfused regions in the ictal studies. Three interictal studies revealed no abnormal perfusion. Scalp EEG provided localization information in five patients. Conclusion: These initial results suggest that ictal SPECT with Tc-99m-bicisate is a more promising tool for the identification of epileptogenic foci than interictal SPECT or scalp EEG in patients without focal abnormalities on MRI.

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Documento generato il 01/04/20 alle ore 02:16:28