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目的 通过比较MRI、发作间期18 F-脱氧葡萄糖(FDG)及11 C-氟马西尼(FMZ)PET显像的定侧、定位准确性,探讨3种方法对经典型海马硬化(HS)难治性癫癎(REP)的诊断效能.方法回顾性分析2017年1月至2018年10月于解放军北部战区总医院行手术治疗、术后病理诊断为经典型HSREP的41例(男25例,女16例;年龄15～61岁)患者.患者均在颗叶致癎灶切除术前行MRI、发作间期18 F-FDG及11 C-FMZ PET/CT显像.以术后病理诊断为“金标准”.采用目测法及半定量法分析图像,采用 χ2检验比较3种方法对经典型HSREP的定侧、定位准确性.结果MRI对致癎灶的定侧、定位准确性分别为70.73％(29/41)和60.98％(25/41);发作间期18 F-FDG PET/CT显像的定侧、定位准确性分别为78.05％(32/41)和70.73％(29/41);发作间期11 C-FMZ PET/CT显像的定侧、定位准确性均为100％(41/41),优于另2种方法(χ2值:1.976～12.902,均P<0.01).结论3种显像方法均有其优点及局限性,其中发作间期11 C-FMZ PET/CT显像对经典型HSREP的定侧、定位有较高价值,有助于指导临床手术.“,”Objective To compare the lateralization accuracy and localization accuracy of MRI, interictal 18 F-fluorodeoxyglucose(FDG)and 11 C-flumazenil(FMZ)PET/CT imaging for refractory epilepsy (REP)in patients with hippocampal sclerosis(HS).Methods A total of 41 classical HS patients (25 males,16 females;age:15-61 years)with REP from General Hospital of Northern Theater Command of PLA between January 2017 and October 2018 were retrospectively analyzed.All patients underwent MRI, interictal 18 F-FDG and 11 C-FMZ PET/CT imaging,followed by the resection of epileptogenic foci.The path-ological diagnosis was taken as the gold standard.Visual and semi-quantitative analyses were used to analyze the images.The lateralization accuracy and localization accuracy of the three imaging methods for epilepto-genic foci were calculated and compared(χ2 test).Results The lateral accuracy and localization accuracy of MRI were 70.73％(29 /41)and 60.98％(25 /41),those of interictal 18 F-FDG PET/CT imaging were 78.05％(32 /41)and 70.73％(29 /41),and those of interictal 11 C-FMZ PET/CT imaging were 100％(41 /41)and 100％(41 /41),respectively.The interictal 11 C-FMZ PET/CT imaging was the best among 3 ima-ging methods(χ2 values:1.976-12.902,all P<0.01).Conclusions All 3 imaging methods have their ad-vantages and limitations.The interictal 11 C-FMZ PET/CT imaging has a high value in the localization of classical HSREP,which can significantly improve the diagnostic accuracy of classical HSREP and guide clinical operation.