Swartz B W, Khonsari A, Vrown C, Mandelkern M, Simpkins F, Krisdakumtorn T
Veterans Administration Medical Center, Los Angeles, California, U.S.A.
Epilepsia. 1995 Apr;36(4):388-95. doi: 10.1111/j.1528-1157.1995.tb01014.x.
We evaluated three techniques of analyzing 18FDG-positron emission tomography-(PET) scans in 23 cases of presumed frontal lobe epilepsy (FLE): routine visual or "qualitative linear," "qualitative normalized," and quantitative normalized approaches. Patients were then classified as having pure frontal, probable frontal, frontoparietal and frontotemporal epilepsy based on prolonged surface EEG monitoring with video, magnetic resonance imaging (MRI), chronic intracranial recording (CIR), and results of surgical excision. Overall sensitivity and accuracy of the scans was 52 and 48%for qualitative linear analysis, which was equivalent to that of MRI, and 69 and 43% for qualitative normalized analysis. Quantitative normalized analysis had 96% sensitivity and 74 - 78% accuracy and also detected 9 of 11 (81%) abnormalities in nonlesional cases, improving routine sensitivity from 1 of 11 (9%). We conclude that qualitative linear (routine) analysis is inadequate for diagnosis of FLE lobe or "frontal-plus" epilepsies and does not add to the MRI scan. Because qualitative normalized images improve on routine analysis only slightly, quantitative techniques should be applied for preoperaive evaluations.
我们评估了三种分析18氟脱氧葡萄糖正电子发射断层扫描（PET）的技术，用于23例疑似额叶癫痫（FLE）患者：常规视觉或“定性线性”、“定性归一化”和定量归一化方法。然后根据长时间的视频脑电图监测、磁共振成像（MRI）、慢性颅内记录（CIR）以及手术切除结果，将患者分为单纯额叶、可能额叶、额顶叶和额颞叶癫痫。定性线性分析扫描的总体敏感性和准确性分别为52%和48%，与MRI相当；定性归一化分析的敏感性和准确性分别为69%和43%。定量归一化分析的敏感性为96%，准确性为74 - 78%，还检测出11例非病变病例中的9例（81%）异常，将常规敏感性从11例中的1例（9%）提高。我们得出结论，定性线性（常规）分析不足以诊断FLE叶或“额叶加”癫痫，且对MRI扫描无补充作用。由于定性归一化图像仅比常规分析略有改善，因此术前评估应采用定量技术。
