目的 探讨常规磁共振成像(MRI) 和氢质子磁共振波谱成像(1 H-MRS)在癫痫 海马硬化中的诊断价值。方法 选取2016 年2月至2017年11月在我院治疗的癫痫患 者50例，行常规MRI扫描、液体衰减反转 恢复序列(FLAIR)、T2W-FLAIR序列、GMonly序列及1 H-MRS扫描。结果 MRI检出异 常者共29例，检出率为58.00%，准确定位 率为68.97%；1 H-MRS检出异常者41例，检 出率为82.00%，准确定位率为90.24%， 1 H-MRS检出率和定位准确率明显高于 MRI(P＜0.05)；患侧海马NAA/(Cho+Cr)、 NAA/Cr和NAA/Cho分别为(0.44±0.12)、 (0.92±0.30)和(1.00±0.53)，明显 低于对侧海马(P＜0.05)；患侧和对侧 海马Cho/Cr比较差异无统计学意义(P＞ 0.05)。结论 MRI和1 H-MRS在癫痫患者海 马硬化诊断中有较好的应用价值，其中 1 H-MRS检出率和定位准确率较高，可定量 分析患者脑组织生化代谢异常。

Objective To explore the value of conventional magnetic resonance imaging (MRI) and hydrogen proton magnetic resonance spectroscopy (1 H-MRS) in the diagnosis of hippocampal sclerosis in epileptic patients. Methods A total of 50 cases of epileptic patients who were treated in our hospital from February 2016 to November 2017 were selected, the routine MRI scan, fluid attenuated inversion recovery sequence (FLAIR), T2W-FLAIR sequence, GM-only sequence and 1 H-MRS scan were performed. Results A total of 29 cases of abnormal were detected by MRI, the detection rate was 58% and the accurate location rate was 68.97%. 41 cases of abnormal were detected by 1 H-MRS, the detection rate was 82.00%, the accurate location rate was 90.24%, and the detection rate and location accuracy of 1 H-MRS were significantly higher than that of the MRI (P<0.05). The NAA/(Cho+Cr), NAA/Cr and NAA/Cho in the affected side of the hippocampus were (0.44±0.12), (0.92±0.30) and (1.00±0.53), which were significantly lower than those in the contralateral hippocampus (P<0.05). There was no statistically significant difference in Cho/Cr between the affected side and the contralateral hippocampus (P>0.05). Conclusion MRI and 1 H-MRS has good application value in the diagnosis of hippocampal sclerosis in epileptic patients, of which 1 H-MRS detection rate and location accuracy rate are relatively high, which can quantitatively analyze brain tissue biochemical metabolism abnormalities.