Matheja P, Diehl B, Kuwert T, Stodieck S R, Schäfers M, Schäfers K, Schuierer G, Ringelstein E B, Schober O
Kliniken und Polikliniken für Nuklearmedizin, Westfälische Wilhelms-Universität Münster, Deutschland.
Nuklearmedizin. 1998 Mar;37(2):43-8.
One approach to regionally analyze temporal glucose consumption consists in drawing linear profiles over the maximal values measured in the temporal cortical ribbon. The aim of our study was to test the reproducibility of this method and to compare its diagnostic performance to that of visual analysis in patients with complex partial seizures (CPS).
Regional cerebral glucose consumption (rCMRGIc) was measured interictally in 25 CPS patients and 10 controls using F-18-deoxyglucose and the positron emission tomography (PET) camera ECAT EXACT 47. The PET scans were visually analyzed for the occurrence of unilateral temporal hypometabolism. Furthermore, rCMRGIc was quantified on six contiguous coronal planes by manually tracing maximal values of temporal glucose consumption, thus creating line profiles of temporal glucose consumption for each side. Indices of asymmetry (ASY) were then calculated from these line profiles in four temporal regions and compared to the corresponding 95% confidence intervals of the control data. All analyses were performed by two observers independently from each other and without knowledge of the clinical findings.
The agreement between the two observers with regard to focus lateralization was 96% (kappa = 0.93) on visual analysis and 100% (kappa = 1) on quantitative analysis. There was an excellent agreement with regard to focus lateralization between visual and quantitative evaluation (kappa = 0.8).
Quantitation of local temporal rCMRGIc by using linear profile analysis is highly reproducible; for the lateralization of epileptogenic foci, however, this method does not possess significant advantages over the visual evaluation of the scans.
对颞叶葡萄糖消耗进行区域分析的一种方法是在颞叶皮质带测量的最大值上绘制线性剖面图。我们研究的目的是测试该方法的可重复性，并将其诊断性能与复杂部分性癫痫（CPS）患者的视觉分析诊断性能进行比较。
使用F-18-脱氧葡萄糖和正电子发射断层扫描（PET）相机ECAT EXACT 47对25例CPS患者和10名对照者进行发作间期区域脑葡萄糖消耗（rCMRGIc）测量。对PET扫描进行视觉分析，以确定单侧颞叶低代谢的情况。此外，通过手动追踪颞叶葡萄糖消耗的最大值，在六个连续的冠状面上对rCMRGIc进行量化，从而为每一侧创建颞叶葡萄糖消耗的线性剖面图。然后从四个颞叶区域的这些线性剖面图中计算不对称指数（ASY），并与对照数据的相应95%置信区间进行比较。所有分析均由两名观察者独立进行，且彼此不知道临床结果。
在视觉分析中，两名观察者关于病灶定位的一致性为96%（kappa = 0.93），在定量分析中为100%（kappa = 1）。视觉评估和定量评估在病灶定位方面具有极好的一致性（kappa = 0.8）。
使用线性剖面图分析对局部颞叶rCMRGIc进行定量具有高度可重复性；然而，对于癫痫病灶的定位，该方法与扫描的视觉评估相比没有显著优势。
