Influence of technetium-99m-hexamethylpropylene amine oxime injection time on single-photon emission tomography perfusion changes in epilepsy.
Influence of technetium-99m-hexamethylpropylene amine oxime injection time on single-photon emission tomography perfusion changes in epilepsy.
复制标题
锝-99m-六甲基丙烯胺肟注射时间对癫痫单光子发射断层扫描灌注变化的影响。
DOI：
10.1007/s002590050353
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Spencer,SS
中科院分区：
文献类型：
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作者：
Zubal,IG;Spanaki,MV;MacMullan,J;Corsi,M;Seibyl,JP;Spencer,SS
本文报道了一种用于定位致痫区域的增强方法，通过数字计算从发作或发作后（周）注射到发作间获得的灌注变化。对19例癫痫患者注射锝-99m六甲基丙烯胺肟（HMPAO）并获取单光子发射断层扫描（SPET）数据后，应用基于计算机的图像处理方法定量脑区域百分比变化。每个患者的癫痫发生区域通过病理和/或成功的手术独立定位。以99mtc - hmpao初始注射时间为函数绘制正、负定量灌注变化。该时间尺度相对于癫痫发作持续时间进行了规范化，并参考了癫痫发作终止的时间。8例经静脉注射的患者，在已知的癫痫发生区显示灌注增加25%-100%。5例患者在癫痫发作停止后立即注射，显示与癫痫发作区域相关的过度灌注减少30%-92%。6例患者在癫痫终止后注射，在致痫区表现出少于30%的低灌注改变。99mtc - hmpao SPET扫描计算的灌注变化，作为归一化时间的函数，支持从尖峰期高灌注到过度低灌注，然后最后到持续的间期低灌注的进展。通过应用灌注模式模型，并在周周图像上记录注射时间，证明了一种改进的定位癫痫区方法。
By digitally computing perfusion changes from ictal or postictal (peri-ictal) injections referenced to those acquired interictally, an enhanced method for localizing the epileptogenic area is reported. Computer-based image processing methods for quantifying regional percent change in the brain are applied to a group of 19 epilepsy patients after the injection of technetium-99m hexamethylpropylene amine oxime (HMPAO) and after acquiring single-photon emission tomography (SPET) data. Each patient’s region of epileptogenesis was independently localized through pathology and/or successful surgery. The positive and negative quantitative perfusion changes were plotted as a function of the time of the99mTc-HMPAO ictal injection. This time scale was normalized relative to the seizure duration and is referenced to the time of seizure termination. Eight patients, injected ictally, demonstrated perfusion increases of 25%–100% in the area of known epileptogenesis. Five patients, injected immediately after seizure cessation, demonstrated excessive perfusion decreases of 30%–92% associated with the region of seizure onset. Six patients, injected well after seizure termination, demonstrated hypoperfusion changes less than 30% at the epileptogenic area. Observations on perfusion changes calculated from99mTc-HMPAO SPET scans, as a function of normalized time, support a progression from ictal hyper- to excessive hypo-, then finally to persistent interictal hypoperfusion. By applying this perfusion pattern model and by noting the time of injection for peri-ictal images, an improved method for localizing the epileptogenic area is demonstrated.