发作间期颞叶癫痫的18F-FDG PET 显像研究

目的：采用诊断试验评价方法评估发作间期^18F-FDG PET显像对颞叶癫痫定性和病业定位的诊断价值，探讨其外科治疗的意义。方法：26例CT或MRI检查正常，经临床及脑电图诊断的颞叶癫痫患者在同期进行发作间期^18F-FDG PET脑显像，图像通过目测和半定量的方法进行分析，PET显示的低代谢区行皮层脑电图（EcoG）或深部脑电图（DEEG）描记以评估^18F-FDG PET检测癫痫灶的特异性，17例定位明确的单侧颞叶癫痫行前颞叶切除术，术手进行随访。2例PET未检出癫痫灶，7例DEEG定位双侧病灶未行手术治疗。结果：26例颞叶癫痫中，发现^18F-FDG PET对癫痫灶检出的灵敏度为92%（24/26），特异度为87%(21/24)。结论：从颞叶癫痫的定性定位诊断来看，发作间期^18F-FDG PET脑显像对癫痫灶的检出率较高，但^18F-FDG PET显示的低代谢区与癫痫灶的位置并非完全重叠，尚需要其他的诊断措施加以肯定，^18F-FDG PET和皮层脑电图或深部脑电图对癫痫病灶定位的一致性是手术成功的关键。

Study of intericatal 18F-FDG PET in temporal lobe epilepsy

Objective To explore the value of directing to surgical teatment, qualitative and localizing epileptic foci of interictal 18 F FDG PET for temporal lobe epilepsy. Methods Interictal 18 F FDG PET brain imaging was perfrmed on 26 patients with normal CT or MRI. Their diagnosis of temporal lobe epilepsy were provde by clinical history and EEG. The imaging was analyzed by eyes and semi quantitative. The diagnostic specificity of 18 F FDG PET was evaluated by ECoG or depth electroencephalography during operation. 18 cased had been operated and followed up. 2 patients were excluded because of no finding epileptic foci, the other 7 cases were bilaterial temporal foci.Results The sensitivity of localizing epileptic foci by interictal 18 F FDG PET was 92%, and the specificity was 87%.Conclusions Interical 18 F FDG PET has high potenial ability in the detection of epileptic foci, but the accurate location of epileptic foci can't be confirmed only by the hypometabolistic area in 18 F FDG PET imaging. Combined 18 F FDG PET and ECoG would be of higher predictive value in the detection of epileptic foci. The localizing results of 18 F FDG PET in concordance with ECoG or DEEG was the hypothesis of complementary effect.