epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLC10.17749/2077-8333/epi.par.con.2024.173epilepsia-998Research ArticleSCIENTIFIC SURVEYSНАУЧНЫЕ ОБЗОРЫSubtraction ictal single-photon emission computed tomography (SPECT) co-registered to MRI (SISCOM) in presurgical diagnostics of epilepsyОднофотонная эмиссионная компьютерная томография с протоколом SISCOM в предхирургической диагностике эпилепсииhttps://orcid.org/0000-0002-8480-2814ИшмуратовЕ. В.IshmuratovE. V.

Ишмуратов Евгений Валерьевич – врач-невролог неврологического отделения Центра нейрохирургии

ул. Нижняя Первомайская, д. 70, Москва 105203, Россия

Evgeny V. Ishmuratov – Neurologist, Neurological Department, Neurosurgery Center

70 Nizhnyaya Pervomayskaya Str., Moscow 105203, Russia

ei-doc@yandex.ruhttps://orcid.org/0000-0003-2974-1462ЗуевА. А.ZuevA. A.

Зуев Андрей Александрович – заведующий нейрохирургического отделения

ул. Нижняя Первомайская, д. 70, Москва 105203, Россия

Scopus Author ID: 26424155600;

Andrey A. Zuev – Head of Neurosurgical Department

70 Nizhnyaya Pervomayskaya Str., Moscow 105203, Russia

Scopus Author ID: 26424155600

Федеральное государственное бюджетное учреждение «Национальный медико-хирургический центр им. Н.И. Пирогова» Министерства здравоохранения Российской ФедерацииРоссияPirogov National Medical and Surgical CenterRussian Federation2024160420241616976Copyright © Ishmuratov E.V., Zuev A.A., 20242024Ишмуратов Е.В., Зуев А.А.Ishmuratov E.V., Zuev A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/998

Success of surgically treated epilepsy depends on the accuracy of epileptogenic zone localization. Single-photon emission computed tomography (SPECT) using SISCOM (subtraction ictal SPECT co-registered to MRI) protocol is the only imaging method that allows identification of ictal onset zone by injection and fixation of a special radioactive tracer in the area of increased cerebral blood flow. The review outlines the key stages of SPECT using SISCOM protocol, generalizes and analyzes data for related opportunities and disadvantages as well as its prospects for use in preoperative examination of patients with epilepsy. It was demonstrated that the technique showed high sensitivity (mean 70–75%) to localize epileptogenic zone in patients with pharmacoresistant epilepsy in case if brain structural changes were not detected by magnetic resonance imaging (MRI). However, the organizational features of the procedure in combination with its specific limitations for epilepsy patients do not allow it to be considered as a routine diagnostic method.

Успешность хирургического лечения эпилепсии зависит от точности локализации эпилептогенной зоны. Однофотонная эмиссионная компьютерная томография (ОФЭКТ) с применением протокола SISCOM (англ. subtraction ictal SPECT co-registered to MRI) является единственным методом визуализации, который позволяет идентифицировать зону иктального начала путем введения и фиксации специального радиоактивного трейсера в области усиления мозгового кровотока. В обзоре представлены ключевые этапы проведения ОФЭКТ с применением протокола SISCOM, обобщены и проанализированы данные о возможностях и недостатках данного метода, а также о перспективах его применения в предоперационном обследовании пациентов с эпилепсией. Показано, что методика имеет высокую чувствительность (в среднем 70–75%) в локализации эпилептогенной зоны у пациентов с фармакорезистентной эпилепсией, когда структурные изменения головного мозга не выявляются при магнитно-резонансной томографии. Однако организационные особенности проведения процедуры в сочетании с ее специфическими ограничениями в отношении больных эпилепсией не позволяют рассматривать ее как рутинный диагностический метод.

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The authors declare that there are no conflicts of interest present.