突发性聋患者3D-FLAIR MRI表现与其临床特征及疗效预后的相关性分析  

3D-FLAIR MRI findings in idiopathic sudden sensorineural hearing loss and the correlations with clinical features and prognosis

作　　者：王明明[1] 王英俊 胡娜 许清安 孙晓[1] 侯志强[1] 樊兆民[4] 王海波 Wang Mingming;Wang Yingjun;Hu Na;Xu Qing′an;Sun Xiao;Hou Zhiqiang;Fan Zhaomin;Wang Haibo(Department of Otological Medicine,Shandong Provincial ENT Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250022,China;Imaging Department,Shandong Second Provincial General Hospital,Jinan 250022,China;Shandong Institute of Otolaryngology,Jinan 250022,China;Department of Otology Center,Shandong Provincial ENT Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250022,China)

机构地区：[1]山东大学附属山东省耳鼻喉医院耳内科,济南250022 [2]山东省第二人民医院影像科,济南250022 [3]山东省耳鼻喉研究所,济南250022 [4]山东大学附属山东省耳鼻喉医院耳科中心,济南250022

出　　处：《中华耳鼻咽喉头颈外科杂志》2021年第5期424-430,共7页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：山东省重点研发计划(2019GSF108248);山东省泰山学者工程(ts20130913)。

摘　　要：目的探讨突发性聋患者内耳3D-FLAIR MRI不同表现与其临床特征及预后的相关性。方法回顾性分析2017年5月至2019年1月山东省耳鼻喉医院耳内科住院治疗的单侧突发性聋患者的临床资料,依据内耳3D-FLAIR MRI表现分为内耳高信号吸收组、高信号未吸收组和内耳正常信号组,分析三组间临床特征(性别、耳聋侧别、年龄、入院时病程、治疗天数、伴发头/眩晕、基础疾病、前庭功能、耳聋分级和分型)和预后的差异及相关性。应用SPSS 20.0软件进行统计学分析。结果共收集到资料完整的突发性聋患者1245例,其中内耳正常信号组739例(59.36%),内耳高信号未吸收组288例(23.13%),内耳高信号吸收组218例(17.51%)。临床特征中侧别比、治疗天数、头/眩晕伴发率、前庭功能异常率、听力损失分级和分型,三组间差异均有统计学意义(P值均<0.001)。侧别比,内耳高信号吸收组和未吸收组均是右侧发病居多,右侧发病比例明显高于内耳正常信号组;前庭功能异常率,内耳高信号吸收组显著高于内耳正常信号组和高信号未吸收组;治疗天数、头/眩晕伴发率、听力损失分型和分级,组间两两比较差异均具有统计学意义,以内耳高信号吸收组治疗时长及损伤表现最为显著,其次是高信号未吸收组。疗效分析,总有效率三组间比较,差异无统计学意义(P=0.139),但痊愈率三组间比较差异有统计学意义(P<0.001)。疗效与临床特征相关性:内耳正常信号组,疗效与病程、年龄、治疗天数和头/眩晕伴发率显著相关(P值均<0.001);内耳高信号吸收组,疗效与病程和治疗天数显著相关(P值均<0.001);内耳高信号未吸收组,疗效仅与病程显著相关(P<0.001)。结论突发性聋患者内耳3D-FLAIR MRI表现与其临床特征及疗效预后密切相关,3D-FLAIR MRI有助于了解内耳病理状态,有望成为具有疾病评估作用的影像学新指标。Objective To explore the correlations of different appearances of labyrinthine 3D-FLAIR MRI with clinical features and prognosis in patients with idiopathic sudden sensorineural hearing loss(ISSNHL).Methods Clinical data of patients with unilateral ISSNHL hospitalized from May 2017 to January 2019 were retrospectively analyzed.According to the results of 3D-FLAIR MRI,the patients were divided into three groups including hyperintense with absorption,hyperintense without absorption and normal.The differences and correlations among the three groups in clinical characteristics(gender,age,deafness side,duration,treatment days,dizziness/vertigo,basic diseases,vestibular function,deafness classification and typing)and prognosis were analyzed by SPSS 20.0 software.Results Data were collected from 1245 cases,including 739(59.36%)with normal signal,288(23.13%)hyperintense without absorption,and 218(17.51%)hyperintense with absorption.The side ratio,treatment days,dizziness/vertigo incidence,vestibular dysfunction,deafness classification and typing were different among the three groups(P<0.001).The incidence of right side was significantly higher in both the hyperintense with and without absorption groups than that in the normal.The vestibular dysfunction was more common in the hyperintense with absorption group than in the normal and hyperintense without absorption groups.It showed statistical differences in the dizziness/vertigo incidence,deafness classification,treatment days,and deafness typing compared between groups,which was the most significant in the hyperintense with absorption group,followed by the hyperintense without absorption group.There was no statistical difference in the total effective rate among the three groups(P=0.139),whereas a significant difference in the recovery rate(P<0.001).The prognosis was significantly correlated with duration,age,treatment days and dizziness/vertigo in the normal group(all P<0.001),correlated with duration and treatment days in the hyperintense with absorption group(both P<0

关 键 词：听觉丧失 突发性 磁共振成像 临床特征 预后 

分 类 号：R764.437[医药卫生—耳鼻咽喉科] R445.2[医药卫生—临床医学]