基于三维准连续动脉自旋标记技术的单侧突发感音神经性耳聋患者脑血流灌注改变分析  

Analysis of cerebral blood perfusion changes in patients with unilateral sudden sensorineural hearing loss based on three-dimensional pseudo-continuous arterial spin labeling

作　　者：李海梅[1] 吕宽 陈悦 高文文 刘冰[2] 杨奡偲 桑春玉[1] 耿薇 王伯轩 马国林[2] Li Haimei;Lyu Kuan;Chen Yue;Gao Wenwen;Liu Bing;Yang Aocai;Sang Chunyu;Geng Wei;Wang Boxuan;Ma Guolin(Department of Radiology,Fu Xing Hospital,Capital Medical University,Beijing 100038,China;China-Japan Friendship Hospital,Clinical Medical College of Peking University,Beijing 100029,China)

机构地区：[1]首都医科大学附属复兴医院放射科,北京100038 [2]中日友好医院放射科,北京100029

出　　处：《中华医学杂志》2022年第19期1417-1422,共6页National Medical Journal of China

基　　金：国家重点研发计划(2020YFC2003903,2020YFC2007301,2019YFC0120903);国家自然科学基金(81971585);广州市科技计划(202103010001);北京市科技计划(Z211100003521009)。

摘　　要：目的采用三维准连续动脉自旋标记(3D pCASL)技术, 探索单侧突发感音神经性耳聋(SSNHL)患者的脑血流灌注改变。方法回顾性收集2020年11月至2021年6月首都医科大学附属复兴医院32例单侧SSNHL患者的临床资料与动脉自旋标记技术(ASL)数据, 其中男7例, 女25例, 年龄17~73(44.9±14.4)岁。按耳聋发生位置不同分为左侧SSNHL(L-SSNHL)组(18例)与右侧SSNHL(R-SSNHL)组(14例)。从社会招募无耳聋的健康志愿者34名作为对照组, 男14名, 女20名, 年龄24~68(46.2±14.4)岁。采用CereFlow软件进行数据后处理, 得到各个脑区的脑血流量(CBF)参数。使用基于MATLAB的Brainnetome Atlas软件包进行可视化。采用独立样本t检验比较单侧SSNHL组与健康对照(HC)组脑血流灌注的差异。采用Pearson相关分析评价脑灌注改变与临床量表评分之间的相关性。结果 L-SSNHL组左侧眶回5区、颞下回7区和右侧眶回5区、颞下回1区、颞下回7区、海马旁回3区的CBF值均高于对照组[(49.1±8.8)比(31.6±10.9)ml·100g^(-1)·min^(-1), (42.8±14.3)比(27.1±13.6)ml·100g^(-1)·min^(-1), (51.8±9.4)比(27.2±11.2)ml·100g^(-1)·min^(-1), (38.8±5.7)比(28.0±9.2)ml·100g^(-1)·min^(-1), (38.4±13.8)比(23.6±10.3)ml·100g^(-1)·min^(-1), (42.4±9.4)比(30.1±12.6)ml·100g^(-1)·min^(-1);均P<0.05];左侧额上回7区、额中回3区的CBF值均低于对照组[(48.2±7.9)比(59.3±13.7)ml·100g^(-1)·min^(-1);(46.4±10.3)比(59.3±16.9)ml·100g^(-1)·min^(-1);均P<0.05]。R-SSNHL组左侧眶回5区和右侧眶回5区、颞下回1区、颞下回7区的CBF值均高于对照组[(50.6±7.0)比(31.6±10.9)ml·100g^(-1)·min^(-1);(50.9±8.8)比(27.2±11.2)ml·100g^(-1)·min^(-1);(38.0±7.2)比(28.0±9.2)ml·100g^(-1)·min^(-1);(35.7±8.5)比(23.6±10.3)ml·100g^(-1)·min^(-1);均P<0.05];右侧脑岛4区的CBF值低于对照组[(44.2±6.1)比(54.4±11.3)ml·100g^(-1)·min^(-1), P=0.018]。L-SSNHL组左侧额上回7区、右侧眶回5区的CBF值与耳鸣响度视觉模拟Objective To explore the changes of cerebral blood perfusion in patients with unilateral sudden sensorineural hearing loss(SSNHL)by using the three-dimensional pseudo-continuous arterial spin labeling(3D pCASL)technique.Methods The clinical characteristics and ASL data of the 32 patients with unilateral SSNHL were retrospectively collected from November 2020 to June 2021 in Beijing Fuxing Hospital of Capital Medical University,among them,there were 7 males and 25 females,aged from 17 to 73(44.9±14.4)years.According to the location of SSNHL,they were divided into the left SSNHL(L-SSNHL)group(18 cases)and the right SSNHL(R-SSNHL)group(14 cases).A total of 34 healthy volunteers,which including 14 males and 20 females,aged from 24 to 68(46.2±14.4)years were enrolled from the local community.The parameter of cerebral blood flow(CBF)of each brain area was obtained using the CereFlow software.The Brainnetome Atlas software package based on MATLAB was used for visualization.The independent-samples t test was conducted to compare the difference of cerebral blood perfusion between the unilateral SSNHL group and healthy control(HC)group.Pearson correlation analysis was used to evaluate the correlation between changes in cerebral blood perfusion and clinical scale scores.Results The CBF of left orbital gyrus part 5,left inferior temporal gyrus part 7,right orbital gyrus part 5,right inferior temporal gyrus part 1,right inferior temporal gyrus part 7,and right parahippocampal gyrus part 3 of the L-SSNHL group were higher than that in the HC group[(49.1±8.8)vs(31.6±10.9)ml·100g^(-1)·min^(-1);(42.8±14.3)vs(27.1±13.6)ml·100g^(-1)·min^(-1);(51.8±9.4)vs(27.2±11.2)ml·100g^(-1)·min^(-1);(38.8±5.7)vs(28.0±9.2)ml·100g^(-1)·min^(-1);(38.4±13.8)vs(23.6±10.3)ml·100g^(-1)·min^(-1);(42.4±9.4)vs(30.1±12.6)ml·100g^(-1)·min^(-1);all P<0.05].The CBF of left superior frontal gyrus part 7 and left middle frontal gyrus part 3 of the L-SSNHL group were lower than that in the HC group[(48.2±7.9)vs(59.3±13.7)ml·100g^(-1)

关 键 词：自旋标记物 动脉 突发感音神经性耳聋 磁共振成像 脑灌注 病例对照研究 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]