在手术前中使用99m的Tc-HMPAO进行直径和直径间的SPECT. I:预测价值和方法考虑
Martin Prener1, Veronica Drejer1, Morten Ziebell2
1Department of Neurology, Neurobiology Research Unit, Rigshospitalet Blegdamsvej, Copenhagen, Denmark.
Epilepsia open
|July 19, 2023
概括
在ictal减去单光子发射计算机断层扫描 (SPECT) 中注射标记剂后确定发作持续时间可以提高成功手术结果的预测. 这种方法提高了手术成功的积极预测值 (PPV).
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 放射学 放射学是一门学科.
背景情况:
- 手术的目的是切除发作焦点.
- 精确地定位发作焦点对于手术成功至关重要.
- 阴影减去单光子发射计算机断层扫描 (SPECT) 与磁共振成像 (MRI) (SISCOM) 共同注册,用于定位焦点.
研究的目的:
- 调查SISCOM对成功手术的预测价值.
- 为了确定注射追踪剂后的发作持续时间是否会影响SISCOM的预测准确性.
- 基于SISCOM期间不同持续时间的外科结果进行比较.
主要方法:
- 对57名接受SISCOM手术评估的患者进行了回顾性研究.
- 根据注射痕迹剂后的发作持续时间 (≥30s vs <30s) 将患者分为两组.
- 将SISCOM的发现与手术地点进行了比较;为良好的手术结果计算了几率比率 (OR) 和正预测值 (PPV).
主要成果:
- 第1组 (持续时间≥30秒) 的PPV为74.1%,OR为5.71,意味着手术结果良好.
- 第二组 (持续时间<30秒) 的PPV为40%,OR为0.22.
- 无论焦点在同一半球内的相同或邻近的叶片,SISCOM都展示了类似的PPV.
结论:
- 一个精确的定义,用于执行好 ictal SPECT 扫描,考虑到发作持续时间,增强PPV和OR成功的手术.
- 这种精细的方法在预测外科手术结果方面超过了以前的发现.
- 注射后的发作持续时间是优化SISCOM在手术规划中的实用性的关键因素.
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