Brain SPECT in mesial temporal lobe epilepsy: comparison between visual analysis and SPM.
OBJECTIVE
To compare the accuracy of SPM and visual analysis of brain SPECT in patients with mesial temporal lobe epilepsy (MTLE).


METHODS
Interictal and ictal SPECTs of 22 patients with MTLE were performed. Visual analysis were performed in interictal (VISUAL(inter)) and ictal (VISUAL(ictal/inter)) studies. SPM analysis consisted of comparing interictal (SPM(inter)) and ictal SPECTs (SPM(ictal)) of each patient to control group and by comparing perfusion of temporal lobes in ictal and interictal studies among themselves (SPM(ictal/inter)).


RESULTS
For detection of the epileptogenic focus, the sensitivities were as follows: VISUAL(inter)=68%; VISUAL(ictal/inter)=100%; SPM(inter)=45%; SPM(ictal)=64% and SPM(ictal/inter)=77%. SPM was able to detect more areas of hyperperfusion and hypoperfusion.


CONCLUSIONS
SPM did not improve the sensitivity to detect epileptogenic focus. However, SPM detected different regions of hypoperfusion and hyperperfusion and is therefore a helpful tool for better understand pathophysiology of seizures in MTLE.
Amorim
Bárbara Juarez
BJ
Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas State University, Campinas, SP, Brazil. juarezbarbara@hotmail.com
Ramos
Celso Darío
CD
dos Santos
Allan Oliveira
AO
de Lima
Mariana da Cunha Lopes
Mda C
Min
Li Li
LL
Camargo
Edwaldo Eduardo
EE
Cendes
Fernando
F
Etchebehere
Elba Cristina Sá de Camargo
EC
D000328:Adult; D001921:Brain / Q000098:blood supply; D001931:Brain Mapping / Q000379:methods*; D016022:Case-Control Studies; D002908:Chronic Disease; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon