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目的:探讨n 18F-脱氧葡萄糖(FDG)PET/MR对常规MRI阴性的药物难治性癫n 患者术前致n 灶的定位价值。n 方法:回顾性分析2016年8月至2018年12月间在首都医科大学宣武医院接受手术治疗的57例[男36例、女21例，年龄(24.0±10.3)岁]常规MRI阴性的药物难治性癫n 患者资料。所有患者术前均行发作间期n 18F-FDG PET/MR扫描，采用视觉及半定量方法综合定位致n 灶。术后1年随访，根据Engel分级评价手术疗效，以手术切除病变及术后随访结果为定位诊断的“金标准”，计算n 18F-FDG PET/MR定位致n 灶的灵敏度、特异性和准确性。n 结果:89.5%(51/57)的患者n 18F-FDG PET/MR表现为1处或多处葡萄糖代谢减低，10.5%(6/57)的患者未见异常葡萄糖代谢改变。18例(31.6%，18/57)常规MRI阴性的药物难治性癫n 患者n 18F-FDG PET/MR图像上检出微小结构异常。46例患者获得术后1年随访，癫n 症状改善者(Engel Ⅰ～Ⅲ级)占84.8%(39/46)。n 18F-FDG PET/MR定位致n 灶的灵敏度、特异性、准确性分别为90.0%(27/30)、3/16、65.2%(30/46)。n 结论:对于常规MRI阴性药物难治性癫n 患者，n 18F-FDG PET/MR有助于致n 灶术前定位，为手术治疗提供可靠信息。n “,”Objective:To explore the accuracy of n 18F-fluorodeoxyglucose (FDG) PET/MR in preoperative localization of refractory epilepsy patients with conventional MRI negative.n Methods:From August 2016 to December 2018, 57 refractory epilepsy patients (36 males, 21 females, age (24.0±10.3) years) with conventional MRI negative who underwent surgery in Xuanwu Hospital were retrospectively enrolled. All patients received interictal n 18F-FDG PET/MR before surgery and the epileptogenic foci were determined by using visual and semi-quantitative methods. Patients were followed up for 1 year and the surgical outcome was evaluated according to Engel classification. The sensitivity, specificity and accuracy of n 18F-FDG PET/MR in locating epileptogenic foci were calculated according to surgical resection and followed-up results as the “ gold standard” .n Results:Of 57 patients, 51(89.5%, 51/57) showed single or multiple hypo-metabolism focus on n 18F-FDG PET/MR, and 6(10.5%, 6/57) showed no abnormal metabolism changes. The microstructure abnormality was found in 18 patients (31.6%, 18/57) on n 18F-FDG PET/MR images. Follow-up results were obtained from 46 patients, and 84.8%(39/46) with seizure improvement (Engel Ⅰ-Ⅲ). The sensitivity, specificity and accuracy of n 18F-FDG PET/MR in preoperative localization of epileptic foci was 90.0%(27/30), 3/16 and 65.2%(30/46), respectively.n Conclusion:18F-FDG PET/MR is helpful for the detection of epileptic foci in patients with MRI-negative refractory epilepsy, and can provide reliable information for further surgical treatment.n