目的 探讨磁共振(MRI)脑显像 对颞叶癫痫致痫灶定侧的诊断价值。方 法 对21例健康志愿者及78例资料完整的 难治性颞叶癫痫(TLE)患者进行回顾性分 析，对常规MRI、氢质子磁共振波谱(1 HMRS)检查及二者联合诊断在TLE定侧中的 诊断准确率进行比较评价。结果 常规MRI 检查及1 H-MRS检查分别准确定侧诊断26及 46例患者。经统计学分析，致痫灶侧NAA/ (Cho+Cr)值低于健侧，并低于健康志愿 者双侧颞叶相应比值，有诊断学意义。 可以认为常规MRI与1 H-MRS(χ2 =10.317， P=0.001)、两者联合(χ2 =12.443，P ＜0.001)差异均有统计学意义; 尚不 能认为1 H-MRS与两者联合(χ2 =0.107， P=0.744)间差异有统计学意义。结论 常 规MRI及1 H-MRS在颞叶癫痫定侧诊断中具 有较大临床应用价值，二者联合应用可提 高癫痫定侧准确率，在利用MRI对颞叶癫 痫进行定位诊断时应尽量在常规MRI检查 的基础上加行1 H-MRS检查。

Objective To evaluate the value of MRI in the localization of temporal lobe epileptic focus. Methods 21 healthy volunteers and 78 patients diagnosed as TLE were all examined by conventional MRI and 1 H-MRS. The accuracies of these two methods and combined application of the two methods were compared. Results We accurately diagnosed 26 and 46 patients using the routine MRI and 1 H-MRS examination respectively. After statistical analysis, we found the ratio of NAA/(Cho+Cr) was lower than that of the healthy side and corresponding value in healthy volunteers. As a result, we found the difference between conventional MRI and 1 H-MRS(χ2 =10.317,P=0.001), combined application(χ2 =12.443,P＜0.001) was statistically significant. We could not find the difference between the 1 H-MRS and the combined application were statistically significant(χ2 =0.107,P=0.744). Conclusion Conventional MRI and 1 H-MRS have great clinical application value in diagnosis of temporal lobe epilepsy, but the conventional MRI and 1 H-MRS examination should be carried out at the same time owing to the accuracy of 1 H-MRS was significantly higher than that of conventional MRI.