磁共振3D-CISS序列诊断梅尼埃病的价值和限度  

Value and Limitation of Magnetic Resonance 3D-CISS Sequence in the Diagnosis of Meniere′s Disease

作　　者：黄耀渠[1] 赵晓梅[1] 秦红卫[1] 周守国[1] 伍琼慧[1] 

机构地区：[1]佛山市中医院MRI室,广东528000

出　　处：《放射学实践》2010年第3期293-296,共4页Radiologic Practice

基　　金：广东省佛山市卫生局医学科研立项课题(2009110)

摘　　要：目的:探讨磁共振3D-CISS序列诊断梅尼埃病(MD)的价值和限度。方法:回顾性分析22例MD患者和20例健康志愿者的内耳3D-CISS序列图像,观察耳蜗、前庭、半规管、内淋巴管和内淋巴囊的显示情况,测量后半规管至颞骨岩部后缘的最短距离(PP值)并绘制工作者特征曲线(ROC)曲线。结果:3D-CISS序列不能区分内、外淋巴。健康志愿者内淋巴管和内淋巴囊的显示率仅为7.5%,MD患者为4.5%,其差异无统计学意义(P>0.05)。MD患者PP值为(1.55±1.48)mm,健康志愿者为(3.30±1.06)mm,两者差异有统计学意义(t=6.20,P<0.001),其ROC曲线下面积为0.81(95%可信区间0.72～0.91),最佳诊断截断点为2.04mm,诊断敏感度为72.7%,特异性度85.0%。结论:3D-CISS序列虽然尚不能直接显示内淋巴积水,但能显示后半规管内侧颞骨发育不良,对MD的诊断和治疗有一定作用。Objiective：To investigate the value and limitation of magnetic resonance 3D-CISS sequence in the diagnosis of Meniere＇s disease （MD）.Methods：The MR 3D-CISS images of internal ear in 22 MD patients and 20 normal volunteers were analyzed retrospectively,the visibility of cochlea,vestibule,semicircular canals,endolymphatic duct and endolymphatic sac was evaluated.The minimum distance between the posterior semicircular canal and the posterior petrous surface （PP value） was measured in axial plane,and the ROC curve was established.Results：Endo- and peri-lymph system could not be distinguished by 3D-CISS sequence.The endolymphatic duct and endolymphatic sac was only visualized in 7.5% of normal volunteers and 4.5% of MD patients with no significant statistical difference （P〉0.05）.The PP value of MD patients was （1.55±1.48）mm,and of normal volunteers was （3.30±1.06）mm,with significant statistical difference （t=6.20,P〈0.001）.The area under ROC curve reached 0.81 （95% CI 0.72～0.91）,the best cut off point was 2.04mm,with the sensitivity as 72.7%,specificity as 85.0% for the diagnosis of MD.Conclusion：Although the straight demonstration of endolymphatic hydrops is not yet possible on 3D-CISS sequence,but dysplasia of inner temporal bone could be displayed and had definite value in the diagnosis and treatment of MD.

关 键 词：梅尼埃病 磁共振成像 诊断 

分 类 号：R764[医药卫生—耳鼻咽喉科]