HIGH-RESOLUTION INTERICTAL SPET AND PHASED-ARRAY MRI IN PARTIAL EPILEPSY - AN IMAGING COMPARISON WITH VIDEO EEG AND OUTCOME CORRELATION/

To assess the clinical utility of high-resolution inter-ictal single p hoton emission tomography (SPET) of regional cerebral perfusion and hi gh-resolution magnetic resonance imaging (MRI) of the brain with a pha sed-array temporal lobe coil, 35 patients with presumed partial epilep sy were evaluated prospectively by these techniques in addition to pro longed video/electroencephalographic (EEG) monitoring. Twenty of these patients had surgical treatment of partial epilepsy with outcome dete rminations spanning from 12 months to 3 years at follow-up. There were four categories of imaging findings as compared to scalp/sphenoidal E EG localization. Category I included 12 patients (34% of total) in who m there was complete imaging and EEG concordance. Category II included 4 patients (11%) in whom MRI and EEG were concordant but SPET was div ergent or normal. Category III included 13 patients (37%) in whom SPET and EEG were concordant but MRI was divergent or normal. Category IV included 4 patients (11%) in whom neither SPET nor MRI was concordant with EEG. In this study, the relative sensitivities of SPET and MRI fo r localization of partial epilepsy based on prolonged scalp/sphenoidal video/EEG recordings were 76% and 49%, respectively. We conclude that these neuroimaging techniques (phased-array MRI and inter-ictal cereb ral perfusion SPET) are complementary and useful in the pre-operative evaluation of patients with partial epilepsy. ((C) 1998 Chapman & Hall Ltd.).