内耳道膜迷路磁共振三维快速液体衰减反转恢复序列检查在突发性聋中的应用  

Application of inner labyrinthine delayed 3D f luidattenuated inversion recovery in sudden sensorineural hearing loss

作　　者：郭良蓉[1] 田永胜[1] 马荣[1] 张彦 王淑珍[1] 张秀菊[1] GUO Liangrong;TIAN Yongsheng;MA Rong;ZHANG Yan;WANG Shuzhen;ZHANG Xiuju(Department of Otolaryngology, Aerospace Center Hospital, Beijing, 100049, China)

机构地区：[1]航天中心医院耳鼻咽喉科

出　　处：《中国耳鼻咽喉头颈外科》2019年第5期252-255,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的评估内耳道膜迷路磁共振三维快速液体衰减反转恢复序列(three-dimensional fluid-attenated inversion recovery,3D-FLAIR)在突发性聋诊治中的应用。方法根据内耳道膜迷路3D-FLAIR结果,将2017年1月~2018年6月我科收治60例突发性聋患者分为3D-FLAIR阳性组和阴性组,对两组听力学特点、是否伴有眩晕等及预后进行分析和比较。结果 3D-FLAIR阳性组较阴性组眩晕发生率更高,差异有显著性(P=0.001);3D-FLAIR阳性组听力曲线以全聋型频或平坦型为主,且阳性组较阴性组听力损失更严重,预后更差。结论听力损失较重尤其伴眩晕的突发性聋,若其内耳道膜迷路3D-FLAIR显示内耳有可能存在延迟强化征象,其预后较阴性组欠佳。建议对所有突发性聋患者,常规行内耳道膜迷路3D-FLAIR检查,有助于判断预后。OBJECTIVE To assess the application of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) delayed contrast-enhanced magnetic resonance imaging (MRI) of the membranous labyrinth in the diagnosis and treatment of sudden deafness. METHODS Based on the results of 3D-FLAIR delayed contrast-enhanced MRI of membranous labyrinth, 60 cases with sudden deafness treated at our hospital from January 2017 to June 2018 were divided into positive enhancement group and negative enhancement group. The audiological characteristics (the presence and absence of vertigo) and prognosis were analyzed and compared between the two groups. RESULTS The incidence of vertigo in the positive enhancement group was significantly higher than that of the negative enhancement group (P=0.001). In the positive enhancement group, pure-tone audiograms were predominantly of flat type or complete deafness type at all frequencies. Even the hearing loss was more severe in the positive enhancement group than in the negative enhancement group, and the former had worse prognosis. CONCLUSION For sudden deafness with severe hearing loss and vertigo, if there was delayed enhancement membranous labyrinth in the 3D-FLAIR delayed contrast-enhanced MRI, the prognosis was worse compared to those without such enhancement. It was suggested that for all patients with sudden deafness, conventional 3D-FLAIR delayed contrast-enhanced MRI of the membranous labyrinth should be performed to predict the prognosis.

关 键 词：听觉丧失 突发性 磁共振成像 血-迷路屏障 3D-FLAIR 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]