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Der Nuklearmediziner 2007; 30(3): 212-216
DOI: 10.1055/s-2007-981213
Nuklearmedizinische Gehirndiagnostik

© Georg Thieme Verlag Stuttgart · New York

SPECT und PET in der Diagnostik von Epilepsien

SPECT and PET Imaging in EpilepsiaC. Landvogt1
  • 1Klinik und Poliklinik für Nuklearmedizin der Universität Mainz
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Publication History

Publication Date:
31 August 2007 (online)

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Zusammenfassung

Die nuklearmedizinische Bildgebung ist integraler Bestandteil der Lokalisationsdiagnostik epileptogener Zonen vor einer operativen Therapie. Die FDG-PET ist als einfach durchzuführende Methode meist Methode der ersten Wahl. Bei inkonklusiven Befunden des EEG, MRT und des FDG-PET sollte eine iktale und interiktale Perfusions-SPECT, oder - sofern verfügbar - eine 11C-Flumazenil-PET erfolgen. Zur Bestimmung der Ausdehnung des zu resezierenden Gebietes ist bei extratemporalen Epilepsien die 11C-Flumazenil-PET hilfreich, die FDG-PET ist dazu nicht geeignet. Unabhängig vom verwendeten Tracer ist eine erweiterte Bildanalyse mittels voxelbasiertem statistischen Vergleich mit einem Normalkollektiv oder mittels SISCOM (substraction ictal SPECT coregistered MRI) zur Steigerung der Sensitivität und Spezifität zu empfehlen.

Abstract

In preoperative localisation of epileptogenic foci, nuclear medicine diagnostics plays a crucial role. FDG-PET is used as first line diagnostics. In case of inconsistent MRI, EEG and FDG-PET findings, 11C-Flumazenil-PET or ictal and interictal perfusion-SPECT should be performed. Other than FDG, Flumazenil can help to identify the extend of the region, which should be resected. To enhance sensitivity and specificity, further data analysis using voxelbased statistical analyses or SISCOM (substraction ictal SPECT coregistered MRI) should be performed.

Schlüsselwörter

Epilepsie - SPECT - PET - nuklearmedizinische Bildgebung

Key words

epilepsia - SPECT - PET - nuclear medicine - imaging

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Dr. C. Landvogt

Klinik und Poliklinik für Nuklearmedizin · Universitätsklinik Mainz

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55101 Mainz

Phone: +49/61 31/17 24 48

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Email: landvogt@nuklear.klinik.uni-mainz.de