突发性耳聋的椎-基底动脉DSA表现及经椎动脉内灌注前列地尔治疗的初步研究  

Digital Subtraction Angiography Abnormalities in 30 Adults with Sudden Sensorineural Hearing Loss and Evaluation of Alprostadil Injection Into the Vertebral Artery

作　　者：刘源[1] 邓晓筑[2] 周立[2] 谢慧[2] 何春水[1] 廖华强[1] 刘洋[1] 张丽峰[1] 曾伟[1] 张勤修[2] 

机构地区：[1]成都中医药大学附属医院血管外科.介入治疗中心,610072 [2]成都中医药大学附属医院耳鼻喉科,610072

出　　处：《临床放射学杂志》2010年第6期805-808,共4页Journal of Clinical Radiology

摘　　要：目的分析突发性耳聋(sudden sensorineural hearing loss,SSNHL)患者椎-基底动脉系统DSA的表现特点及经椎动脉灌注前列地尔的疗效。资料与方法对30例SSNHL患者分别在两侧椎动脉行DSA检查,分析椎动脉、基底动脉、小脑前下动脉(AICA)、内听动脉的影像学表现,然后经导管在椎动脉灌注前列地尔(平均剂量5μg,灌注时间5min)。术后1周复查听力,观察听力改善情况。结果 30例均成功进行上述检查、治疗,无相关并发症出现。30例中,2例出现一侧椎动脉闭塞,5例椎动脉硬化。分别有23.3%(7/30)的右侧AICA和30.0%(9/30)的左侧AICA呈现缺失或细小改变,63.3%(19/30)的右侧内听动脉和73.3%(22/30)的左侧内听动脉呈现缺失或细小改变。术后纯音听阈测试显示听阈水平(500Hz、1000Hz、2000Hz、4000Hz听阈的平均值)平均升高28.2dBHL,其中痊愈2例,显效8例,有效15例,无效5例,总有效率83.3%。结论 SSNHL与内听动脉、AICA细小、缺失导致的内耳缺血有关,灌注扩张血管的药物能够改善症状,提高听力。Objective To identify the anatomic abnormalities in patients with sudden sensorineural hearing loss（SSNHL）using digital subtraction angiography and outcomes of Alprostadil injection via the vertebral artery.Materials and Methods Thirty patients were included in the study.Bilateral vertebral arteries（VAs）were selectively catheterized in all the patients and 5 ug Alprostadil in average was injected into the vertebral artery within 5 minutes.One week later,the outcome was evaluated.Results In 2 patients the VA on the affected side was not visualized after injection of iodixanol.The proximal segment of the AICA in 5 patients on the affected side was not well filled,possibly due to vasculitis or atherosclerosis.In some patients AICA became smaller in caliber.Conclusion The DSA information provided herein will hopefully help to clarify some aspects of the etiology and pathology of sudden sensorineural hearing loss.One week postoperatively,the audiogram revealed improvement of the ear thresholds.

关 键 词：突发性耳聋 椎-基底动脉系统 内听动脉 血管造影 

分 类 号：R764[医药卫生—耳鼻咽喉科]