Comparison of statistical parametric mapping and SPECT difference imaging in patients with temporal lobe epilepsy
Comparison of statistical parametric mapping and SPECT difference imaging in patients with temporal lobe epilepsy
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DOI：
10.1046/j.1528-1157.2002.21601.x
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发表时间：
2002-01-01
期刊：
影响因子：
5.6
通讯作者：
Blumenfeld, H
中科院分区：
文献类型：
--
作者：
Chang, DJ;Zubal, IG;Blumenfeld, H
目的：统计参数映射（SPM）是一种图像分析工具，它可以逐个体素地评估脑血流量（CBF）变化的统计学意义，从而消除传统感兴趣区域（ROI）分析中固有的主观性。我们的单光子发射计算机断层扫描（SPECT）脑电差异成像在临床癫痫的平台已被验证为定位癫痫发作。我们扩展SPM的工具，进一步应用统计学方法来衡量个体患者灌注变化的意义，在本初步研究中使用配对扫描来定位颞叶癫痫患者的致痫灶。方法：在这项SPECT差异成像和SPM差异分析之间的比较研究中，通过使用配对的正常健康图像。这12例患者的癫痫灶位于内侧颞叶，经手术结果和病理学海马硬化证实。SPNI被用来确定集群的增加或减少CBF在每个病人在对比我们的control group.Results：该地区有最显着的增加或减少的CBF SPM分析与传统的差异成像和视觉分析的观众盲目的SPM分析的结果确定的地区。通过放射性药物注射时间进一步区分，在癫痫发作100 s内注射的7例患者中有6例显示两种技术定位于相应致癫痫颞叶的过度灌注变化。在接受注射后100秒的患者中，这两种技术主要表现为低灌注区，这再次是这两种方法之间的相似性。结论：结果提供了强有力的证据支持SPM差异分析评估区域的显着CBF变化从基线与我们目前的临床使用的SPECT发作-发作间期的差异成像癫痫患者的技术一致。SPM的差异分析可作为颞叶癫痫发作病灶的诊断工具。
Purpose: Statistical parametric mapping (SPM) is an image-analysis tool that assesses the statistical significance of cerebral blood flow (CBF) changes on a voxel-by-voxel basis, thereby removing the subjectivity inherent in conventional region-of-interest (ROI) analysis. Our platform of single-photon emission computed tomography (SPECT) interietal difference imaging in clinical epilepsy has been validated for localizing seizure onset. We extend the tools of SPM by further applying statistical measures for the significance of perfusion changes in individual patients to localize epileptogenic foci in patients with defined temporal lobe epilepsy by using paired scans in this preliminary study.Methods: Twelve patients with pairs of periictal and interictal SPECT scans were analyzed in this comparison study between SPECT difference imaging and SPM difference analysis by using a reference database of paired normal healthy images. These 12 patients possessed seizure foci localized to the mesial temporal lobe as confirmed by surgical outcome and by hippocampal sclerosis on pathology. SPNI was used to identify clusters of increased or decreased CBF in each patient in contrast to our control group.Results: The regions having the most significant increased or decreased CBF by SPM analysis were in agreement with regions identified by conventional difference imaging and visual analysis by viewers blinded to the results of the SPM analysis. Differentiated further by time of radiopharmaceutical injection, six of seven patients injected within 100 s of seizure onset displayed hyperperfusion changes localized to the corresponding epileptogenic temporal lobe by both techniques. Among patients receiving injections after 100 s, both techniques showed primarily regions of hypoperfusion, which again were similar between these two methods.Conclusions: The results provide strong, evidence supporting SPM difference analysis in assessing regions of significant CBF change from baseline in concordance with our current clinically used technique of SPECT ictal-interictal difference imaging in epilepsy patients. Difference analysis using SPM could serve as a useful diagnostic tool in the evaluation of seizure focus in temporal lobe epilepsy.