单侧突发性聋患者迷路多参数MRI信号分析  

Multi-parameter MRI signal analysis of labyrinth in patients with sudden deafness

作　　者：王紫仪 林毅 索红娜 张宗锐[1] 王翰菁[3] 郝欣平[3] 李永新[3] 杨本涛[1] Wang Ziyi;Lin Yi;Suo Hongna;Zhang Zongrui;Wang Hanjing;Hao Xinping;Li Yongxin;Yang Bentao(Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;CT/MRI Room,Yantaishan Hospital of Yantai City,Shandong Province,Yantai 264001,China;Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院放射科,100730 [2]山东省烟台市烟台山医院CT/MR室,264001 [3]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730

出　　处：《中华放射学杂志》2021年第8期829-834,共6页Chinese Journal of Radiology

摘　　要：目的分析单侧突发性聋患者内耳MRI序列的信号特点,探讨各序列临床应用价值。方法回顾性分析2016年1月至2019年7月首都医科大学附属北京同仁医院52例单侧突发性聋患者内耳MRI,均可发现迷路信号异常,其中平扫17例、平扫+增强扫描35例,扫描序列包括平扫T_(1)WI、增强T_(1)WI、平扫三维液体衰减反转恢复(3D-FLAIR)及增强延迟3D-FLAIR序列。分析各序列患侧迷路的信号特点并判断迷路受累的部位;对各序列检出迷路异常信号的能力进行评分。分别采用Friedman检验和Wilcoxon符号秩和检验比较平扫及增强患者中不同序列显示迷路高信号能力的主观评分;采用Fisher确切概率法分析迷路受累部位与听力、耳鸣及眩晕症状恢复与否的关系。结果52例(100%,52/52)患者患侧T_(1)WI迷路显示高信号,T2WI显示更高信号8例(15.4%,8/52)、低信号3例(5.8%,3/52)。增强T_(1)WI显示患侧高信号35例(100%,35/35),其中27例(77.1%,27/35)见病变强化。52例(100%,52/52)患侧迷路于3D-FLAIR(平扫17例,增强35例)序列上均显示明显高信号。平扫T_(1)WI、增强T_(1)WI、平扫3D-FLAIR及增强3D-FLAIR显示迷路高信号能力的主观评分分别为2(2,2)、3(2,3)、3(3,4)及4(4,4)分。增强患者中平扫T_(1)WI、增强T_(1)WI及增强3D-FLAIR的主观评分总体差异有统计学意义(χ^(2)=64.528,P<0.001),两两间比较差异均有统计学意义(校正后P均<0.05)。患者平扫3D-FLAIR评分高于平扫T_(1)WI,差异有统计学意义(Z=-3.729,P<0.001)。3D-FLAIR图像显示后、上半规管壶腹部显著高信号27例(51.9%,27/52),在听力恢复与否分布中差异有统计学意义(P=0.001)。结论T_(1)WI及3D-FLAIR均可有效发现迷路高信号,但后者较前者显示能力好,尤其是延迟增强3D-FLAIR序列,半规管壶腹部明显高信号为听力无恢复的特征性指标。Objective To explore the clinical application value of each sequence by analyzing the characteristics of labyrinthine signal on MRI in patients with unilateral sudden deafness.Methods Totally 52 patients of unilateral sudden deafness with inner ear MRI were analyzed retrospectively at Beijing Tongren Hospital,Capital Medical University from January 2016 to July 2019,all of which could find abnormalities in the labyrinth,including 17 cases of plain scan and 35 cases of enhanced scan,with sequences including plain T_(1)WI,enhanced T_(1)WI,plain and enhanced delayed 3D fluid attenuation inversion recovery(3D-FLAIR).The affected labyrinthine signal characteristics of each sequence were analyzed and the involvement sites were judged.The ability of each sequence to show labyrinthine abnormal signal was evaluated and scored.The Friedman test and Wilcoxon signed rank sum test were used to compare the subjective scores of the ability to show labyrinthine high signal in different sequences in plain and enhanced patients,respectively.Fisher′s exact probability method was used to analyze the relationship between the affected sites and the recovery of hearing,tinnitus and vertigo symptoms.Results Fifty-two patients(100%,52/52)showed labyrinthine high signal on T_(1)WI,8(15.4%,8/52)showed higher signal and 3(5.8%,3/52)showed low signal on T2WI.Thirty-five(100%,35/35)showed high signal on enhanced T_(1)WI,among which 27 had enhancement(77.1%,27/35).Fifty-two(100%,52/52)showed significant high signal of the affected labyrinth on 3D-FLAIR(17 plain scan,35 enhanced scan).The scores were 2(2,2),3(2,3),3(3,4)and 4(4,4)of T_(1)WI,enhanced T_(1)WI,plain and enhanced 3D-FLAIR respectively.The overall difference in subjective scores of plain T_(1)WI,enhanced T_(1)WI and enhanced 3D-FLAIR in enhanced patients was statistically significant(χ^(2)=64.528,P<0.001),and the comparison between the two was statistically different(all corrected P<0.05).The plain 3D-FLAIR score was higher than the plain T_(1)WI in patients with a statistically

关 键 词：内耳 听觉丧失 突发性 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R764.437[医药卫生—诊断学]