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Ictal single-photon emission computed tomography with slow dye injection for determining primary epileptic foci in infantile spasms.

Other Titles
 영아연축에서 추적자의 느린 점적주사를 이용한 발작기 SPECT 
 Yun Jung Hur  ;  Joon Soo Lee  ;  Hoon ChulKang  ;  Hye Jung Park  ;  MiJin Yun  ;  Heung Dong Kim 
 Korean Journal of Pediatrics, Vol.52(7) : 804-810, 2009 
Journal Title
 Korean Journal of Pediatrics 
Issue Date
Infantile spasms ; Computed tomography ; Single-photon emission
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.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hoon Chul(강훈철) ORCID logo https://orcid.org/0000-0002-3659-8847
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
Hur, Yun Jung(허윤정)
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