Abstract： Objective:To investigate the diagnostic value of 18F-deoxyglucose positron emission computed tomography/computed tomography( 18F-FDG PET/CT), combined 18F-FDG PET/CT and 99mTC-ethyl cysteinate dimer single photon emission computed tomography/computed tomography( 99m TC-ECD SPECT/CT)in refractory epilepsy. Methods:This study was a retrospective study, 61 patients with intractable epilepsy, 36 males and 25 females, who underwent surgical in Bengbu Medical College First Affiliated Hospital between March 2017 and January 2022, the age was(32.46±11.01)years old, ranging from 18 to 58 years old.All patients underwent interictal 18F-FDG PET/CT brain metabolism imaging and all were positive, 18F-FDG PET/CT or 99mTc-ECD SPECT/CT in ictal phase were performed in patients with multifocal lesions that could not be located accurately, to evaluate the diagnostic value of interictal 18F-FDG PET/CT imaging and combined 18F-FDG PET/CT imaging or 99mTc-ECD SPECT/CT imaging in localizing intractable epileptic foci. Results:Of the 61 patients, 23 patients(37.7%)presented as single lesions on 18F-FDG PET/CT, and 38 patients(62.3%)presented as multiple lesions or diffuse lesions that could not be accurately localized on 18F-FDG PET/CT. 18F-FDG PET/CT imaging during seizure was performed in 12 patients, 9 patients(75.0%)of them transformed into single lesion, and 99mTc-ECD SPECT/CT imaging during seizure in 26 patients, 20 patients(76.9%)transformed into single localized hyperperfushion area.In 61 patients, interictal 18F-FDG PET/CT combined with ictal 18F-FDG PET/CT or 99mTc-ECD SPECT/CT imaging was used to accurately localize the epileptogenic focus in 52 patients(85.2%). Conclusions:Interictal PET/CT imaging showed a single focus of intractable epilepsy patients, epileptogenic focus accurate location; For the patients whose PET/CT imaging showed multiple lesions and could not be accurately located, SPECT/CT imaging or PET/CT imaging could be added during the period of attack.The combined application of complementary advantages could significantly improve the localization accuracy of epilepsy lesion location.