발작기 Tc-99m HMPAO 뇌 SPECT에 나타난 교차소뇌과혈류 : 내외측 측두엽간질의 감별에 대한 임상적 의의와 발생에 영향을 주는 요인 ( Crossed Cerebellar Hyperperfusion on Ictal Tc-99m HMPAO Brain SPECT:Clinical Significance for Differentiation of Mesial or Lat () |
Author |
박순아(Soon Ah Park),이동수(Dong Soo Lee),김석기(Seok Ki Kim),이상건(Sang Gun Lee),장명진(Myoung Jin Jang),손명희(Myung Hee Sohn),임석태(Seok Tae Lim),정준기(June Key Chung),이명철(Myung Chul Lee), |
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Affiliation |
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Abstract |
Purpose: The aim of this study was to determine whether
crossed cerebellar hyperperfusion (CCH) was helpful in
discriminating mesial from lateral temporal lobe
epilepsy (TLE) and what other factors were related in
the development of CCH on ictal brain SPECT. Materials
and Methods: We conducted retrospective analysis in 59
patients with TLE (M:41, F:18; 27.4¡¾7.8 years old;
mesial TLE: 51, lateral TLE: 8), which was confirmed by
invasive EEG and surgical outcome (Engel class I , II).
All the patients underwent ictal Tc-99m HMPAO brain
SPECT and their injection time from ictal EEG onset on
video EEG monitoring ranged from 11 sec to 75 sec
(32.6¡¾19.5 sec) in 39 patients. Multiple factors
including age, TLE subtype (mesial TLE or lateral TLE),
propagation pattern (hyperperfusion localized to
temporal lobes, spread to adjacent lobes or
contralateral hemisphere) and injection time were
evaluated for their relationship with CCH using
multiple logistic regression analysis Results: CCH was
observed in 18 among 59 patients. CCH developed in 29%
(15/51) of mesial TLE patients and 38% (3/8) of lateral
TLE patients. CCH was associated with propagation
pattern; no CCH (0/13) in patients with hyperperfusion
localized to temporal lobe, 30% (7/23) in patients with
propagation to adjacent lobes, 48% (11/23) to
contralateral hemisphere. Multiple logistic regression
analysis revealed that propagation pattern (p=0.01) and
age (p=0.02) were related to the development of CCH.
Conclusion: Crossed cerebellar hyperperfusion in ictal
brain SPECT did not help differentiate mesial from
lateral temporal lobe epilepsy. Crossed cerebellar
hyperperfusion was associated with propagation pattern
of temporal lobe epilepsy and age. (Korean J Nucl Med
2000;34:312-21) |
Keyword |
Tc-99m HMPAO, Single photon emission tomography (SPECT), Epilepsy, Crossed cerebellar hyperperfusion |
Full text Article |
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