儿童先天性神经感音性听力下降的内耳及听觉中枢MRI、CT研究  

MRI and CT study of the inner ear and auditory center of congenital sensorineural hearing loss in children

作　　者：买买提明·马合木提 谭娟 张沁 王建新 麦麦提吐尔洪·艾尼瓦尔 努尔买买提·卡斯木 张志飞 高山 Maimaitiming Mahemuti;TAN Juan;ZHANG Qin;WANG Jianxin;Maimaitituerhong Ainiwaer;Nuermaimaiti Kasimu;ZHANG Zhifei;GAO Shan(Imaging Center,the Second People's Hospital of Kashgar,Kashgar 84000,China;Department of Otolarsngology,the Second People's Hospital of Kashgar,Kashgar 84000,China)

机构地区：[1]新疆喀什地区第二人民医院影像中心,新疆喀什844000 [2]新疆喀什地区第二人民医院耳鼻喉科,新疆喀什844000

出　　处：《实用放射学杂志》2021年第3期459-462,共4页Journal of Practical Radiology

基　　金：新疆维吾尔自治区自然科学基金项目(2017D01C086)。

摘　　要：目的研究MRI、CT检查对儿童先天性神经感音性听力下降内耳及听觉中枢畸形临床应用价值。方法回顾性分析经听力筛查中心确诊为重度神经感音性下降患者进行MRI及CT检查91例(MRI 91例、CT 24例),采用西门子1.5T MR进行头颅MRI常规及内耳水成像扫描;CT进行内听道及骨迷路检查。结果根据内耳最新分类标准进行诊断和分型。结果MRI完成91例,CT完成24例;其中前庭导水管扩大21例,耳蜗畸形18例,前庭畸形13例,窝神经畸形9例,半规管畸形6例,内听道发育畸形5例,骨迷路畸形4例;米歇尔畸形1例,顶周融合1例,脑白质发育异常3例,10例患者的MRI、CT表现无异常。结论MRI检查能够较准确判断、评估患儿内耳、蜗神经畸形及发育的状况,并且可对畸形的轻重程度进行归类,CT检查可提供骨性结构及通道的异常,MRI及CT相结合能够提高对该病诊断的精准性、准确性。同时也可指导人工耳蜗植入手术方案的选择、制订;预防术中并发症的发生及判断预后都具有非常重要的临床价值;10例无异常发现的患儿将继续研究检查方法及内在联系。Objective To study the clinical value of MRI and CT examinations in the inner ear and auditory center malformations in children with congenital sensorineural hearing loss.Methods The MRI and CT examinations of 91 children diagnosed with severe sensorineural hearing loss in the hearing screening center were analyzed retrospectively(MRI 91 case,CT 24 case).Routine head MRI and inner ear water imaging,internal auditory canal and bone labyrinth CT examination were conducted by Siemens 1.5T MR and CT.Patients were diagnosed and classified with the latest classification criteria of the inner ear.Results MRI completed 91 cases,CT completed 24 cases.There were 21 cases of enlarged vestibular aqueduct,18 cases of cochlear malformation,13 cases of vestibular malformation,9 cases of fossa nerve malformation,6 cases of semicircular canal malformation,5 cases of internal auditory canal malformation,4 cases of bone labyrinth malformation,1 case of Michel malformation,I case of parietal fusion,3 cases of white matter dysplasia,10 cases with no abnormalities both in MRI and CT.Conclusion MRI examination can diagnose and evaluate the malformations,development of inner ear and cochlear nerve accurately,cassity the degree of deformities.CT examination can provide abnormalities of bony structure and auditory meatus.The combination of MRI and CT can improve the accuracy and precision of the diagnosis.Furthermore,it can also make a great guidance in planning cochlear implant surgery.It has great clinical value to prevent the occurrence of intraoperative com plications and prognosis.Ten children without abnormalities in imaging will be continue to study,both in examination methods and internal relations.

关 键 词：内耳畸形 感音性神经性耳聋:听觉中枢 计算机体层成像 磁共振成像 

分 类 号：R764.3[医药卫生—耳鼻咽喉科] R764.431[医药卫生—临床医学]