Der Nuklearmediziner 2003; 26(4): 300-305
DOI: 10.1055/s-2003-44827
Multimodale Bildgebung

© Georg Thieme Verlag Stuttgart · New York

Klinische Anwendung der Bildfusion in der prächirurgischen Epilepsiediagnostik

Image Registration in the Presurgical Evaluation of EpilepsyC. Vollmar1 , S. Noachtar1
  • 1Neurologische Klinik, Klinikum Grosshadern der Universität München
Further Information

Publication History

Publication Date:
19 December 2003 (online)

Zusammenfassung

Bei manchen Patienten mit medikamentös nur unzureichend behandelbaren fokalen Epilepsien kann eine epilepsiechirurgische Behandlung helfen, wenn es gelingt, den Anfallsursprung zu entfernen. Ziel der prächirurgischen Epilepsiediagnostik ist die genaue Lokalisation des epileptogenen Fokus sowie seine Abgrenzung von gesundem Hirnparenchym. Die Bildfusion ermöglicht die Kombination komplementärer Informationen verschiedener bildgebender Verfahren, insbesondere eine genaue anatomische Lokalisation funktioneller Untersuchungsergebnisse.
Dieser Beitrag beschreibt die Einsatzmöglichkeiten der Bildfusion im Rahmen der prächirurgischen Epilepsiediagnostik, wo sie die diagnostische Wertigkeit einzelner Modalitäten wie PET oder SPECT deutlich erhöhen kann. Eine besondere Bedeutung hat die Bildfusion im Rahmen der anatomisch detaillierten Operationsplanung anhand dreidimensional visualisierter Bildfusionen. Hier kann das konkrete operative Vorgehen durch die Integration multimodaler Befunde am Kortexmodell geplant werden.

Abstract

Some patients with medically intractable focal epilepsies will benefit from epilepsy surgery if the epileptogenic zone can be resected. The aim of presurgical evaluation is the exact localization of the the epileptogenic zone and its relation to eloquent cortex. Image registration allows the integration of complementary information from different imaging modalities, which can improve the diagnostic significance of imaging techniques such as SPECT or PET. The most important advantadge of image registration techniques is the possibility to integrate multimodal imaging results in one 3D-reconstruction of the brain that allows anatomically detailled planning of resective surgery.

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C. Vollmar

Neurologische Klinik

Klinikum Grosshadern

Universität München

Marchioninistr. 15

81337 München

Phone: +49-89-70 95-56 81

Fax: +49-89-70 95-56 84

Email: im@ging.de