Asian Journal of Nuclear Medicine
亞洲核醫學雜志

Volume 1 Number 1, April 2001
Abstract

癲癇發作間期丘腦不對稱性低灌注

張成君,奚保珊,鄭俊忠,林琛,歐陽亮,關楚文,李俊雄
汕頭大學醫學院第一附屬醫院核醫學科,汕頭,515041,中國。

目的 研究癲癇發作間期rCBF SPECT中丘腦不對稱性低灌注及其意義。方法 103例臨床診斷癲癇患者靜脈注射99mTc-ECD後行發作間期rCBF SPECT檢查,並對腦皮質和丘腦灌注進行半定量評價。部分病例與CT和/或MRI影像比較。結果 103例癲癇發作間期rCBF SPECT發現灌注異常者70例(68%)。表現為局部血流灌注減低的62例中31例存在不對稱性丘腦低灌注;其中,5例僅有丘腦低灌注,丘腦和皮層共同累及者26例。CT和MRI均未發現丘腦任何形態學改變。結論 癲癇患者發作間期SPECT存在丘腦不對稱性低灌注,丘腦皮層神經失聯絡(TCD)為其可能機制。提示丘腦在癲癇發作和/或播散中可能起重要作用,並可應用SPECT進行研究。

【關鍵字】癲癇;丘腦;腦血流灌注;神經失聯絡

Asymmetric thalamic hypoperfusion on interictal 99mTc-ECD SPECT in epileptic patients

ZHANG Chengjun, XI Baoshan, ZHENG Junzhong, LIN Chen, OUYANG Liang, GUAN Chuwen, LI Junxiong
Department of nuclear medicine, the First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, China.

Received 29 November 2000 and in revised from 1 March 2001

Objective To investigate the phenomenon of concomitant hypoperfusion of thalamus and cerebral cortex (thalamocortical diaschisis, TCD), on interital rCBF SPECT in epileptic patients. Method 103 patients with epilepsy underwent interictal brain SPECT after intravenous injection of 99mTc-ECD.Perfusion impairments in brain, especially the thalamus, were evaluated quantitatively. CT or/and MRI was performed for some of the patients. Results Perfusion impairment occurred in 70 of 103 patients (68%)with epilepsy on interictal SPECT. 31 of the 62 patients who were observed regional cerebral hypoperfusion showed asymmetric thalamic hypoperfusion, 5 of the 31 patients had only asymmetric thalamic hypoperfusion and other 26 patients showed concomitant decreased perfusion in both the thalamus and cerebral cortex. In addition, none of the patients with thalamic hypoperfusion demonstrated any morphologic abnormalities on MRI or CT. Conclusion Asymmetric thalamic hypoperfusion on interictal brain SPECT in epileptic patients is not uncommon. Thalamocortical diaschisis may be one of the mechanisms of this finding. (Asian J Nucl Med 2001;1:24-26)

Key Words : Epilepsy; Thalamus; Cerebral perfusion; Dischisis



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