听力学检测和内耳磁共振成像在梅尼埃病诊断中的作用  

Audiological Tests and Inner Ear MRI in Diagnosis of Meniere's Disease

作　　者：林有辉[1] 林少莲[1] 叶胜难[1] 舒博[1] 胡婕[1] 林丁丁 LIN Youhui LIN Shaolian YE Shengnan SHU Bo HU Jie LIN Dingding(Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005)

机构地区：[1]福建医科大学附属第一医院耳鼻咽喉头颈外科,福州350005

出　　处：《中华耳科学杂志》2017年第3期290-294,共5页Chinese Journal of Otology

摘　　要：目的探讨多种临床检测方法在梅尼埃病诊断中的应用价值方法回顾性分析2012年1月至2015年12月确诊为梅尼埃病的77例患者的病历资料,分析梅尼埃病患者的听力学检查以及磁共振水成像检查结果。结果共69例纯音测听结果异常(异常率92.3%);接受前庭诱发肌源性电位检测者65例,异常37例,异常率56.9%;接受耳蜗电图检测者22例,结果异常者15例(异常率68.2%);接受冷热气试验者71例,两侧对称比异常者47例,双侧低下者2例,异常率69.0%;接受甘油试验者12例,试验阳性者3例,异常率25.0%;接受磁共振造影者76例,迷路积水者70例,异常率92.1%。结论纯音测听和磁共振造影在梅尼埃病患者中阳性率高,冷热气试验及耳蜗电图假阳性率次之,可作为梅尼埃病观察的参考指标。Objective To report the clinical value of a various audiological tests inner ear MRI in the diagnosis of Meniere＇s disease.Methods Clinical data of 77 patients with Meniere＇s disease diagnosed from Jan.2012 to Dec.2015 were analyzed retrospectively,including pure tone audiometry,glycerol tests,electrocochleogram,caloric tests,vestibular evoked myogenic potentials,inner ear magnetic resonance imaging,etc.Results Unilaterally abnormal pure tone audiometry results were seen in 69 patients（92.3%）.Vestibular evoked myogenic potentials were detected in 65 cases and abnormal in 37 cases（56.9%）.Of the 22 patients who received electrocochleogram tests,15（68.2%） showed abnormal results.Caloric tests were conducted in 71 cases,and showed abnormal results in 49 cases（69.0%） – abnormal symmetry in 47 cases and bilateral weakness in 2 cases.Glycerol test was positive in 3 of the 12 tested patients（25.0%）.In the76 cases that underwent magnetic resonance imaging with contrast,70（92.1%） showed increased fluid volume.Conclusions Pure tone audiometry and magnetic resonance imaging demonstrate higher rates of detection of abnormality,followed by caloric tests and electrocochleography,and can be used as important evidence for the diagnosis of Meniere＇s disease.

关 键 词：梅尼埃病 纯音测听 前庭诱发肌源性电位 耳蜗电图 甘油试验 磁共振造影 

分 类 号：R764[医药卫生—耳鼻咽喉科]