^(123)I-Iomazenil SPECT脑受体显像对癫痫灶定位的价值

^(123) IIomazenil brain receptor SPECT in focal epilepsy: in comparison with^(99m)TcHMPAO brain SPECT, MRI and Video/EEG monitoring

目的探讨１２３ＩＩｏｍａｚｅｎｉｌＳＰＥＣＴ脑受体显像对癫痫灶定位诊断的价值。方法对４０例癫痫病人进行１２３ＩＩｏｍａｚｅｎｉｌＳＰＥＣＴ脑受体显像，并与录像脑电图强化监测（Ｖｉｄｅｏ／ＥＥＧ）、９９ｍＴｃ六甲基丙二胺肟（ＨＭＰＡＯ）ＳＰＥＣＴ脑血流显像和ＭＲＩ检查结果进行对比分析。结果以Ｖｉｄｅｏ／ＥＥＧ癫痫灶检出率９５％（３８／４０）为参照标准，６５８％（２５／３８）癫痫病人脑受体显像异常，表现为局部放射性稀疏，与Ｖｉｄｅｏ／ＥＥＧ定位符合２０例；脑血流显像和ＭＲＩ癫痫灶检出率分别为５５３％（２１／３８）和４７４％（１８／３８），与Ｖｉｄｅｏ／ＥＥＧ定位符合分别为１５例和１６例。１２３ＩＩｏｍａｚｅｎｉｌ脑受体显像联合ＭＲＩ检查，癫痫灶检出率为８４２％（３２／３８）。４例ＭＲＩ、脑血流和受体显像正常患者１８Ｆ脱氧葡萄糖（ＦＤＧ）ＰＥＴ显像全部异常，并均与Ｖｉｄｅｏ／ＥＥＧ定位符合。结论１２３ＩＩｏｍａｚｅｎｉｌＳＰＥＣＴ脑受体显像是癫痫病灶定位的有效方法，与ＭＲＩ配合，能提高病灶检出率。

Purpose To evaluate the clinical value of ^(123) IIomazenil brain receptor SPECT in diagnosis of focal epilepsy in comparison with 99mTcHMPAO brain SPECT, MRI and Video/EEG monitoring Methods ^(123) IIomazenil brain receptor SPECT was performed on 40 patients with focal epilepsy The results were compared with those obtained by 99mTcHMPAO brain SPECT, MRI and Video/EEG monitoring Results In 40 patients, the sensitivity of Video/EEG monitoring for localization of epileptogenic area was 95% (38/40) The sensitivity of 123 IIomazenil brain receptor SPECT, 99mTcHMPAO brain SPECT and MRI for localization of epileptogenic area compared with Video/EEG monitoring (“gold standard”) was 658%(25/38), 553%(21/38) and 474%(18/38), respectively The localization of epileptogenic area with 123 IIomazenil brain receptor SPECT was in concordance with Video/EEG monitoring in 20 patients, 99mTcHMPAO brain SPECT in 15 patients and MRI in 16 patients, respectively The sensitivity of ^(123) IIomazenil brain receptor SPECT combined with MRI for localization of epileptogenic area was 842%(32/38) Conclusions ^(123) IIomazenil brain receptor SPECT is a useful method in detecting and localizing epileptogenic area The combination of ^(123) IIomazenil brain receptor SPECT and MRI has a high sensitivity for detecting epileptogenic area