后天性感音神经性聋患者听觉中枢磁共振弥散张量成像研究  

Diffusion Tensor Imaging Study of Central Auditory Pathway in Patients with Acquired Sensorineural Hearing Loss

作　　者：祝康[1] 何莹[2] 侯瑾[1] 闫静[1] 郑国玺[1] 许珉[1] 白芝兰[2] 

机构地区：[1]西安交通大学医学院第二附属医院耳鼻咽喉头颈外科,西安710004 [2]西安交通大学医学院第二附属医院影像科

出　　处：《听力学及言语疾病杂志》2015年第2期143-146,共4页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金(81271068);陕西省科技攻关项目(2012K14-02-01);西安交大第二附属医院科研青年基金项目(YJ(QN)200913);教育部博士点基金(20120201110060)资助

摘　　要：目的探讨后天性感音神经性聋(sensorineural hearing loss,SNHL)及其病程对听觉中枢白质的影响。方法选后天性SNHL患者30例,根据发病时间分为突发性聋组15例和病程2年以上的SNHL组15例;并选择15例同期行MRI检查的听力正常的其它患者为对照组;运用磁共振弥散张量成像(diffusion tensor imaging,DTI)技术观察各组受试者听觉中枢下丘和外侧丘系的弥散相关参数,包括:部分各向异性(factional anisotropy,FA)值、径向弥散(radial diffusivity,RD)、轴向弥散(axial diffusivity,AD)及平均弥散(mean diffusivity,MD)。结果突聋组、病程2年以上的SNHL组及对照组双侧下丘FA值大小依次为SNHL组<对照组<突聋组(P<0.05),对照组和突聋组与2年以上SNHL组间差异均有统计学意义(P<0.05);外侧丘系右侧RD值大小依次为突聋组<对照组<SNHL组(P<0.05),右侧MD值大小依次为对照组<突聋组<SNHL组,且两两比较差异均有统计学意义(P<0.05)。三组下丘及外侧丘系AD值差异无统计学意义(均P>0.05)。结论突聋患者的听觉中枢未发生明显异常的改变,而病程大于2年以上的后天性SNHL患者听觉中枢神经纤维束明显受到破坏,提示感音神经性听觉损失患者的病程长短对听觉传导通路的结构变化有影响。Objective Magnetic resonance diffusion tensor imaging （DTI） was applied to study the cantral auditong pathway in patients with .Methods A total of 30 cases of acquired hearing loss patients were divided into 2 groups ,group 1 （15 ,sudden deafness） and group 2 （15 ,with duration up to 2 years SNHL group from the time of onset） .A total of 15 cases of normal-hearing patients on MRI examination were selected as the control group for the same period .All subjects received DTI of whole brain .The values of the whole brain DTI were obtained from the inferior colliculus and lateral lemniscus ,consisting of the fractional anisotropy （FA） ,radial diffusion （RD） ,axi‐al dispersion （AD） and mean diffusivity .Results There were significant differences（P〈0 .05） in FA of bilateral in‐ferior colliculus among sudden deafness group ,SNHL of 2 -year -history group and the control group by ANO‐VA .FA of inferior colliculus in the control group was higher than that of in the SNHL group ,but lower than that of in the sudden deafness group .RD of lateral lemniscus in the SNHL group was higher than that of in the sudden deafness group（P〈0 .05） ,MD of lateral lemniscus in the sudden deafness group was higher among the other 2 groups ,and there were signigicant（P〈0 .05） .For AD of the inferior colliculug and lateral lemniscus ,there were no differ‐ences among the 3 groups （P〉0 .05） .Conclusion There was no obviously abnormal change on the central auditory processing in sudden deafness group ,but significant destruction was found on 2 years SNHL group .It indicated that central auditory processing of the history of sensorineural deafness affected the structural changes of the central au‐ditory pathway .

关 键 词：后天性感音神经性聋 磁共振弥散张量成像 听觉传导通路 

分 类 号：R764.431[医药卫生—耳鼻咽喉科]