Swartz Barbara E, Brown Charles, Mandelkern Mark A, Khonsari Ali, Patell Ashok, Thomas Ken, Torgersen Denise, Delgado-Escueta A V, Walsh Gregory O
Department of Neurology, VAMC West Los Angeles, Los Angeles, CA, USA.
Mol Imaging Biol. 2002 May;4(3):245-52. doi: 10.1016/s1095-0397(01)00057-7.
Positron emission tomography with 2-deoxy fluoroglucose positron emission tomography (18-FDG-PET) is widely used in the pre-surgical evaluation of subjects with epilepsy, but little is known of its usefulness in a non-surgical population.
We analyzed the sensitivity of PET as a diagnostic tool in a large unselected population of epilepsy subjects. Pre-surgical and non-surgical portions of this population were individually assessed as well. The relationship of PET abnormalities to other neurodiagnostic tests was examined. Statistical assessment relied primarily on contingency tables (chi-square tests), with ANOVA or non-parametric assessment used as necessary.
While PET was more likely to identify areas of decreased metabolism in the surgical population than in the non-surgical populations, it nevertheless found a significant number of abnormalities in the total population and in the non-surgical group alone. Even in groups in which the clinical diagnosis was unknown, abnormalities were found 40% of the time. PET was useful as an exclusionary diagnostic tool for non-epileptic seizures (NES) and primary generalized epilepsies (PGE) with sensitivity, specificity, and accuracy > 90%. The PET was somewhat more sensitive than magnetic resonance imaging (MRI) in finding abnormalities in the total population, but was less sensitive than electroencephalography (EEG).
PET may be a useful diagnostic tool in the general epilepsy population even when a definitive clinical diagnosis is not suggested by other modalities.
2-脱氧氟葡萄糖正电子发射断层扫描（18-FDG-PET）在癫痫患者的术前评估中被广泛应用，但对于其在非手术治疗人群中的作用却知之甚少。
我们分析了PET作为诊断工具在一大群未经挑选的癫痫患者中的敏感性。该人群的术前和非手术部分也分别进行了评估。研究了PET异常与其他神经诊断测试之间的关系。统计评估主要依赖列联表（卡方检验），必要时使用方差分析或非参数评估。
虽然PET在手术治疗人群中比在非手术治疗人群中更有可能识别出代谢降低的区域，但它在总人群以及仅非手术治疗组中仍发现了大量异常。即使在临床诊断不明的组中，40%的情况下也发现了异常。PET作为非癫痫性发作（NES）和原发性全身性癫痫（PGE）的排除性诊断工具很有用，其敏感性、特异性和准确性均>90%。在发现总人群中的异常方面，PET比磁共振成像（MRI）稍敏感，但比脑电图（EEG）敏感性低。
即使其他检查方法未给出明确的临床诊断，PET在一般癫痫人群中也可能是一种有用的诊断工具。
