前庭阵发症患者高分辨MR和前庭神经功能检查的临床研究  

Clinical study of contradiction and correlation in vestibular paroxysmia from high resolution MR and vestibular function examination

作　　者：周国庆[1] 姜岐涛 韩峰[3] 孔玉[1] 柏燕燕[1] 朱祖福[1] ZHOU Guoqing;JIANG Qitao;HAN Feng;KONG Yu;BAI Yanyan;ZHU Zufu(Department of Neurology,Jiangyin People's Hospital,Jiangyin 214400,China;Department of Imaging,Jiangyin People's Hospital,Jiangyin 214400,China;Department of Nerve Electrophysiology,Jiangyin People’s Hospital,Jiangyin 214400,China)

机构地区：[1]江阴市人民医院神经内科,江苏江阴214400 [2]江阴市人民医院影像科,江苏江阴214400 [3]江阴市人民医院神经电生理室,江苏江阴214400

出　　处：《中国实用神经疾病杂志》2018年第13期1419-1423,共5页Chinese Journal of Practical Nervous Diseases

基　　金：江阴市卫计委指导性项目(Z201602)

摘　　要：目的评估高分辨磁共振影像技术诊断前庭阵发症的敏感性和特异性,进一步分析前庭阵发症血管压迫侧和前庭功能受累侧一致和矛盾特点。方法连续收集20例前庭阵发症患者和20例良性阵发性位置性眩晕患者,运用磁共振三维稳态进动快速成像序列和三维时间飞跃血管成像序列技术,分析第Ⅷ脑神经和血管压迫情况,所有患者进行详细的前庭功能检查。结果高分辨磁共振诊断前庭阵发症敏感度100%,特异度70%,血管压迫距离脑干0~10mm,20例患者中14例(70%)为小脑前下动脉,2例(10%)为小脑后下动脉,2例(10%)为静脉,2例(10%)为椎动脉。5例(25%)前庭神经功能检查无明显异常,9例(45%)表现神经血管压迫侧同前庭神经功能下降或缺失侧一致,6例(30%)神经血管压迫侧同前庭神经功能下降或缺失侧不一致。结论前庭阵发症患者神经血管压迫侧和前庭功能受累侧存在一致和矛盾,联合详细的前庭神经功能检查和高分辨MR可进一步明确前庭阵发症受累侧。Objective To evaluate the sensitivity and specificity of high resolution magnetic resonance imaging in the diagnosis of vestibular paroxysmal disease,and to further analyze the consistent and contradictory features of vascular compression side and vestibular function involvement in vestibular paroxysmal disease.Methods Continuous collection of 20 patients with vestibular paroxysmal disease and 20 patients with benign paroxysmal positional vertigo,using magnetic resonance three dimensional steady state precession rapid imaging sequence and three dimensional time lapse vascular imaging sequence technology to analyze theⅧcranial nerve and vascular compression,All patients underwent detailed vestibular function tests.Results High resolution magnetic resonance diagnosis of vestibular paroxysmal sensitivity is 100%,specificity is 70%,vascular compression is 0 10 mm from brain stem,14 of 20 patients(70%)are anterior inferior cerebellum,and 2 patients(10%)In the posterior inferior cerebellum,2 patients(10%)were veins and 2 patients(10%)were vertebral arteries.Five patients(25%)had no abnormalities in vestibular neurological function tests,and 9 patients(45%)showed neurovascular compression side consistent with vestibular nerve function decline or missing side,and 6 patients(30%)had neurovascular compression side with vestibular nerve function decline.Or missing side inconsistencies.Conclusion There is a consistent and contradictory relationship between the neurovascular compression side and the vestibular function side in patients with vestibular paroxysmal disease.Combined detailed vestibular neurological function tests and high resolution MR can further clarify the affected side of vestibular paroxysmal disease.

关 键 词：前庭阵发症 高分辨磁共振 三维稳态进动快速成像 三维时间飞跃血管成像 前庭神经功能 神经血管压迫 眩晕 前庭蜗神经 

分 类 号：R76[医药卫生—耳鼻咽喉科]