RESUMO
The respective contribution of interictal HMPAO-SPECT and FDG-PET to the imaging of the epileptogenic zone in intractable temporal lobe epilepsy is not known. Ten consecutive patients with drug resistant focal epilepsy of temporal lobe origin were studied with prolonged noninvasive video-EEG monitoring, magnetic resonance imaging, interictal FDG-PET and HMPAO-SPECT. Five patients demonstrated unitemporal and 5 patients bitemporal interictal and/or ictal EEG epileptiform abnormalities. We developed a 3-dimensional semiquantitative method for interpretation and comparison of FDG-PET and HMPAO-SPECT using a 15-compartment model of the temporal lobe. In all 5 patients with unilateral epileptogenicity, interictal hypometabolism and hypoperfusion were recorded on the side of the EEG abnormalities without discrepancy between PET and SPECT. The severity and the extent of focal abnormalities were consistently greater on PET than on SPECT, in agreement with previously well documented better 'sensitivity' of PET. Among the 5 patients with bitemporal epileptogenicity, results of SPECT and PET were convergent in only 2 cases. In this group, SPECT abnormalities appeared more profound but either SPECT or PET were not constantly correlated with the side of predominant EEG epileptogenicity. Abnormalities on PET and SPECT were more frequently limited to mesiobasal structures among cases with unilateral epileptogenicity and tended to involve neocortical structures in bitemporal cases. We conclude that interictal FDG-PET and HMPAO-SPECT provide the same type of information on the side of the epileptogenic zone in cases with clearly unilateral epileptogenicity, with abnormalities more intense and more extensive on PET.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Desoxiglucose/análogos & derivados , Epilepsia Parcial Complexa/diagnóstico por imagem , Epilepsia do Lobo Temporal/diagnóstico por imagem , Compostos de Organotecnécio , Oximas , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada de Emissão , Adulto , Eletroencefalografia , Epilepsia Parcial Complexa/metabolismo , Epilepsia do Lobo Temporal/metabolismo , Feminino , Fluordesoxiglucose F18 , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Reprodutibilidade dos Testes , Método Simples-Cego , Tecnécio Tc 99m Exametazima , Lobo Temporal/irrigação sanguínea , Lobo Temporal/metabolismo , Lobo Temporal/patologia , Gravação de VideoteipeRESUMO
The most serious controversy regarding the application of transaxial SPECT technology to 201Tl myocardial perfusion imaging is the choice between 360 degrees compared with 180 degrees data sampling techniques. The present study utilized the original 360 degrees sampled raw data of 25 patients who had both SPECT 201Tl myocardial perfusion imaging and coronary angio/ventriculography for back projection reprocessing to accomplish the 360 degrees/180 degrees comparison. The results show a high incidence, 36% (9/25), of false-positive segmental perfusion abnormality and a high incidence, 24% (6/25), of moderate to severe degree of image distortion with the 180 degrees data sampled reconstructed images. These were not observed in the 360 degrees data sampled reconstructed images. The above findings confirmed our previous preliminary conclusion that even though the 180 degrees data sampling technique has the advantage of providing improved image contrast and reduction in acquisition time it is not a reliable technique and should be abandoned. The 360 degrees data sampling is the technique of choice for transaxial SPECT 201Tl myocardial perfusion imaging.
Assuntos
Doença das Coronárias/diagnóstico por imagem , Coração/diagnóstico por imagem , Radioisótopos , Tálio , Tomografia Computadorizada de Emissão/métodos , Adulto , Idoso , Angiografia Coronária , Reações Falso-Positivas , Feminino , Humanos , Aumento da Imagem/métodos , Masculino , Pessoa de Meia-IdadeRESUMO
Initial clinical application of a system for digital subtraction angiography (DSA) to the human cardiovascular system in 88 patients is reported. The equipment consisted of a specially designed computer system integrated with a fluoroscopic and radiographic apparatus for digitization, manipulation, and display of data. After intravenous injection of contrast material, adequate visualization of the heart and carotid, thoracic, abdominal, and femoral arteries was obtained with sufficient quality to obviate conventional angiography in many clinical settings. In this mode, nonselective opacification is obtained. However, DSA was also used to extend the capability of selective angiography. The availability of quantitative information permitted the determination of rates of transit of contrast material in various organs which may give insights of their physiologic performance.
Assuntos
Angiografia/métodos , Diagnóstico por Computador/métodos , Aneurisma/diagnóstico por imagem , Aorta Abdominal/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Interna/diagnóstico por imagem , Angiografia Cerebral/métodos , Computadores , Constrição Patológica , Angiografia Coronária , Artéria Femoral/diagnóstico por imagem , Hemangioma/diagnóstico por imagem , Humanos , Neoplasias do Mediastino/diagnóstico por imagem , Artéria Renal/diagnóstico por imagem , Artéria Vertebral/diagnóstico por imagemRESUMO
Total body CT scanning may be utilized as a means of treatment planning for radiation therapy. Computer reconstruction of coronal and sagittal views from CT cross-sectional slices was accomplished by taking each of the cross-sectional images and placing them together in the specific order in the sequence in which they were scanned to form a cube. Once the cube is built, retrieving in the sagittal and coronal views is readily achieved.
