Ictal single-photon emission computed tomography with slow dye injection for determining primary epileptic foci in infantile spasms.
10.3345/kjp.2009.52.7.804
- Author:
Yun Jung HUR
1
;
Joon Soo LEE
;
Hoon Chul KANG
;
Hye Jung PARK
;
Mi Jin YUN
;
Heung Dong KIM
Author Information
1. Department of Pediatrics, Pochon Cha University College of Medicine, Korea. hdkimmd@yumc.yonsei.ac.kr
- Publication Type:Electronic Supplementary Materials ; Original Article
- Keywords:
Infantile spasms;
Computed tomography;
Single-photon emission
- MeSH:
Child;
Cysteine;
Cystine;
Electroencephalography;
Humans;
Infant;
Infant, Newborn;
Magnetic Resonance Imaging;
Organotechnetium Compounds;
Positron-Emission Tomography;
Spasm;
Spasms, Infantile;
Tomography, Emission-Computed;
Tomography, Emission-Computed, Single-Photon
- From:Korean Journal of Pediatrics
2009;52(7):804-810
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We investigated whether ictal single-photon emission computed tomography (SPECT) with prolonged injection of technetium-99m (99mTc) ethyl cysteinate dimer during repeated spasms can localize the epileptogenic foci in children with infantile spasms. METHODS: Fourteen children with infantile spasms (11 boys, 3 girls; mean age, 2.2+/-1.3 years) were examined. When a cluster of spasms was detected during video electroencephalography (EEG) monitoring, 99mTc ethyl cysteinate dimer was slowly and continuously injected for 2 minutes to determine the presence of ictal SPECT. For 7 children, the ictal and interictal SPECT images were visually analyzed, while for the remaining 7 children, the SPECT images were analyzed using the subtraction ictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM) technique. Subsequently, we analyzed the association between the ictal SPECT findings and those of other diagnostic modalities such as EEG, MRI, and positron emission tomography (PET). RESULTS: Increase in cerebral blood flow on ictal SPECT involved the epileptogenic foci in 10 cases6 cases analyzed by visual assessment and 4 analyzed by the SISCOM technique. The ictal SPECT and video-EEG findings showed moderate agreement (Kappa=0.57; 95% confidence interval, 0.18-0.96). CONCLUSION: Ictal SPECT with prolonged injection of a tracer could provide supplementary information to localize the epileptogenic foci in infantile spasms.
