目的 分析磁共振成像(MRI)检查 对癫痫患者海马硬化(HS)的应用价值。 方法 选取2013年1月至2016年12月我院 神经内科诊断颞叶癫痫疑似HS患者147例 作为观察组研究对象，再次选取该时间 段于我院进行体检的124例健康者作为对 照组研究对象。观察并分析癫痫HS患者 MRI诊断率、部分各向异性分数(FA)以及 平均扩散系数(ADC)以及功能学表现。结 果 诊断HS患者136例(92.52%)，双侧HS患 者61例(44.85%)，单侧HS75(57.35%)，31 例患者为右侧HS(21.09)，44例患者为左 侧HS(58.67)；海马区出现肿瘤患者3例 (2.04%)，炎症病变患者为2例(1.36%)， 未见明显异常患者6例(4.08%)；MRI 检测出癫痫患者存在病变患者141例 (95.92%)；MRI影像下观察组患者双侧海 马体积明显低于对照组患者；31例右侧 HS患者FA、ADC值分别明显低于对侧与 对照组数值，差异均具有统计学差异(P ＜0.05)；34例左侧HS患者FA、ADC值分别 明显低于对侧与对照组数值；患侧海马 FA、ADC值与患侧海马体积、病程时间存 在明显线性相关性。结论 MRI能清晰显示 HS形态以及功能学表现，可为临床医务人 员提供精确定位及定性诊断，对患者术前 评估具有重要作用。

Objective To investigate application value of magnetic resonance imaging (MRI) in hippocampal sclerosis (HS) in patients with epilepsy. Methods 147 temporal lobe epilepsy patients with suspected HS treated in the neurology department and 124 cases of health examinees in the medical examination center of our hospital from January 2013 to December 2016 were selected. The MRI diagnostic rate, fractional anisotropy (FA), apparent diffusion coefficient (ADC), and functional manifestations of the selected patients were observed and analyzed. Results 136 cases (92.52%) with HS were diagnosed by MRI, of which 61 cases (44.85%) was bilateral and 75 cases (57.35%) were unilateral with 31 cases (21.09%) being right side and 44 cases (58.67%) left. The proportions of tumor, inflammatory lesions and no obvious abnormalities were 2.04% (3 cases), 1.36% (2 cases) and 4.08% (6 cases). 141 cases (95.92%) were detected with lesions by MRI. MRI showed that the volume of bilateral hippocampus in the observation group was significantly lower than that in the control group (P<0.05). The FA and ADC values of 31 patients with right HS were significantly lower than those of the contralateral and control groups (P<0.05). The FA and ADC values of 34 patients with left hippocampal sclerosis were significantly lower than those of the contralateral and control groups(P<0.05). Moreover, there was a significant linear correlation between the FA and ADC values of the hippocampus and the hippocampal volume and duration of the affected side. Conclusion MRI can clearly display the morphology and functional manifestations of HS, provide accurate location and qualitative diagnosis for clinical treatment, and play an important role in preoperative evaluation of patients.