目的　采用诊断试验评价方法评估发作间期18F FDGPET显像对颞叶癫痫定性和病灶定位的诊断价值 ,探讨其对外科治疗的意义。方法　 2 6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 FDGPET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 FDGPET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 ,术后进行随访。 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　 2 6例颞叶癫痫中 ,发现18F FDGPET对癫痫灶检出的灵敏度为 92 % (2 4 / 2 6 ) ,特异度为 87% (2 1/ 2 4 )。结论　从颞叶癫痫的定性定位诊断来看 ,发作间期18F FDGPET脑显像对癫痫灶的检出率较高 ,但18F FDGPET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 FDGPET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 OBJECTIVE: To evaluate the diagnostic value of 18F FDG PET imaging in qualitative and differential localization of temporal lobe epilepsy by means of diagnostic test evaluation and to explore its significance for surgical treatment. Methods Twenty-six patients with normal temporal CT or MRI were enrolled. The patients with temporal lobe epilepsy who had been diagnosed by clinical and electroencephalographic examination underwent echocardiographic 18F FDGTET imaging during the same period. The images were analyzed by visual inspection and semi-quantitative analysis. PET showed low metabolism The regional ECoG or DEEG tracings were used to evaluate the specificity of 18F FDG PET for the detection of epileptic foci. Seventeen patients with unilateral temporal lobe epilepsy underwent anterior temporal lobe resection and were followed up . 2 cases of PET did not detect epileptic foci, 7 cases of bilateral lesions without DEEG surgical treatment. Results Twenty-six cases of temporal lobe epilepsy were found to have a sensitivity of 92% (24/26) and a specificity of 87% (21/2) for the detection of epileptic foci by 18F FDG PETET. Conclusions From the qualitative diagnosis of temporal lobe epilepsy, the detection rate of epileptic foci in 18F FDG PET brain is high during interictal epilepsy, but the 18F FDGPET does not completely overlap with the location of epileptic foci. Of the diagnostic measures to be affirmed, 18F FDGPET and cortical EEG or deep EEG positioning of epilepsy lesions is the key to the success of the operation