蜗神经发育不良患儿临床特点及影像学表现分析  

Clinical Features and Imaging Findings of Children Patients with Cochlear Nerve Deficiency

作　　者：张淼[1] 王越[2] 张鹏[3] ZHANG Miao;WANG Yue;ZHANG Peng(Department of Pediatrics,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]河南省南阳市中心医院儿科,河南南阳473000 [2]河南省南阳市中心医院检验科,河南南阳473000 [3]南阳理工学院护理学院,河南南阳473000

出　　处：《中国CT和MRI杂志》2020年第4期26-29,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨蜗神经发育不良(CND)患儿临床特点及影像学表现。方法回顾性分析本院2017年6月至2018年7月60例蜗神经发育不良患儿(共120耳)颞骨HRCT扫描和内耳道及内耳MRI表现影像学资料,分析比较其诊断CND的价值。结果MRI显示蜗神经发育不良104耳,其中伴前庭神经异常48耳,伴面神经细小5耳,伴内耳畸形48耳,HRCT显示内耳道狭窄56耳,蜗神经孔狭窄48耳。以MRI显示蜗神经缺失或细小作为诊断CND依据优于以HRCT显示耳蜗神经孔狭窄或封闭作为诊断CND依据(P<0.05);以HRCT显示耳蜗神经孔狭窄或封闭作为诊断CND依据诊断敏感度为89.42%,阴性预测值59.26%高于以HRCT显示内耳道狭窄为诊断敏感度53.84%,阴性预测值25.00%(P<0.05)。结论MRI检查可准确显示CND发生情况,HRCT可通过显示蜗神经孔的狭窄或封闭提示CND状态,内耳道正常情况下并不能排除CND的发生。Objective To explore the clinical features and imaging findings of children patients with cochlear nerve deficiency. Methods The imaging data of HRCT scan of temporal bone and MRI of internal acoustic meatus and inner ear of 60 children patients with cochlear nerve deficiency(120 ears in total) from June 2017 to July 2018 in the hospital were retrospectively analyzed, and their value in the diagnosis of cochlear nerve deficiency was analyzed and compared. Results MRI showed 104 eyes of cochlear nerve deficiency, including 48 eyes with vestibular nerve abnormalities, 5 ears with thin facial nerves and 48 ears with inner ear malformation. HRCT showed 56 ears of internal acoustic meatus stenosis and 48 ears of cochlear foramen stenosis. CND diagnostic basis of MRI showing loss or small size of cochlear nerve was better than that of CND diagnostic basis of HRCT showing stenosis or closure of cochlear foramen(P<0.05). The diagnostic sensitivity and negative predictive value of CND diagnostic basis of HRCT showing stenosis or closure of cochlear foramen were higher than those of HRCT showing stenosis of internal acoustic meatus(89.42% vs 53.84%, 59.26% vs 25.00%)(P<0.05). Conclusion MRI can accurately show the occurrence of CND. HRCT can show the state of CND by showing the stenosis or closure of cochlear foramen, and the normal condition of internal acoustic meatus can not rule out the occurrence of CND.

关 键 词：蜗神经发育不良 临床特点 影像学表现 诊断价值 

分 类 号：R745.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]