MSCT和MRI对人工耳蜗植入术前的评价  

MSCT and MR Imaging in the Preoperative Assessment of Cochlear Implantation

作　　者：马辉[1] 韩萍[1] 孔祥泉[1] 孔维佳[2] 邓先波[1] 冯敢生[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,湖北430022 [2]华中科技大学同济医学院附属协和医院耳鼻咽喉科,湖北430022

出　　处：《放射学实践》2008年第7期722-725,共4页Radiologic Practice

基　　金：湖北省卫生厅科研基金资助项目(JX1B057)

摘　　要：目的:探讨MSCT和MRI对人工耳蜗植入术前的评价方法及其临床价值。方法:对43例拟行人工耳蜗植入术的患者行MSCT和MRI检查,分析其影像学表现,指导临床选择适应证和植入耳侧。结果:43例中20例MSCT和MRI均未发现异常,23例(42耳)MSCT和MRI均发现有异常,其中先天性内耳发育畸形20例39耳:①MicheⅠ型1耳,表现为内耳结构完全缺如;②共同腔畸形3耳,耳蜗和前庭融合呈一囊状结构;③不完全分隔Ⅰ型(IP-Ⅰ型)3耳,耳蜗和前庭均呈囊状,两者轮廓可以区分;④Mondini型5耳,耳蜗仅1.5圈,中圈和顶圈融合,前庭扩大;⑤前庭与半规管畸形13耳:耳蜗正常,前庭扩大,半规管短小、粗大或缺如;⑥前庭导水管扩大14耳,前庭导水管扩大呈喇叭口状或与总脚相通。骨化性迷路炎3例3耳,MSCT表现为内耳迷路内密度不同程度增高,MRI表现为迷路信号减低。MRI显示蜗神经缺如5耳,蜗神经细小2耳。结论:术前MSCT和MRI检查相互补充,应作为常规术前检查。MSCT在显示中耳结构和立体显示内耳畸形的形态方面优于MRI,可指导手术方案的制定和判断预后,MRI对于评价听神经是否正常有重要价值。Objective： To investigate the value of medical imaging in the cochlear implantation before surgery. Methods： Multi-slice CT （MSCT） and magnetic resonance imaging （MRI） were performed in all of the 43 cochlear implantation candidates. The imaging manifestations were analyzed in order to select the suitable patients and ears for cochlea implantation. Results：Of the 43 candidates, no abnormality was showed in 20 cases on both MSCT and MRI. Malformations were found in 23 patients （42 ears）,including 20 patients （39 ears） with inner ear malformations and 3 patients （3 ears） with labyrinthitis ossificans. The inner ear malformations included： （1） Michel type malformation, manifested as total absence of inner ear （1 ear）;（2） common cavity malformation showing cochlea and vestibule merged into one common cavity （3 ears） ;（3） incomplete partition （IP）- Ⅰ ,showing cyst-like cochlear and vestibular cavity,yet the contour of the two could still be delineated （3 ears） ;（4） Mondini malformation, the cochlea had only 1. 5 circle, the mid and top circle were merged,and enlargement of vestibule was revealed （5 ears） ;（5） vestibule and semi-circular canal malformation, with normal cochlea, enlargement of vestibule,shortening,enlargement or absence of semi-circular canal （13 ears） ;（6） vestibular aqueduct enlargement,with bell-like aqueduct or communication with the common limb （14 ears）. Labyrinthitis sclerosis was assessed in 3 patients （3 ears） ,which showed hyper-attenuation of labyrinth and inner ear with various degree on MSCT,and hypo-intensity of vestibule on MRI. Absence of cochlear nerve （5 ears） and cochlear nerve hypoplasia （2 ears） were assessed on MRI. Conclusion： MSCT was superior than MRI in demonstrating the middle ear structure and delineating the pattern of inner ear malformation stereographically,which was helpful in surgical treatment planning and prognosis predicting. MRI was important in the evaluation of auditory

关 键 词：体层摄影术 X线计算机 磁共振成像 耳蜗植入术 内耳 

分 类 号：R445[医药卫生—影像医学与核医学]