多参数磁共振显示听神经瘤患者迷路信号改变的对比分析  

Comparative analysis of signal intensity changes of labyrinth in patients with acoustic neuroma by multiparameter magnetic resonance imaging

作　　者：姜雨薇 王宇辰 王杰[2] 郝欣平[2] 李永新[2] 杨本涛[1] JIANG Yuwei;WANG Yuchen;WANG Jie;HAO Xinping;LI Yongxin;YANG Bentao(Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Departmentof Otology,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,北京100730 [2]首都医科大学附属北京同仁医院耳科,北京100730

出　　处：《中国耳鼻咽喉头颈外科》2022年第11期708-712,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的 比较多参数磁共振显示听神经瘤患者患侧迷路信号改变的效能,寻找识别迷路信号变化的最佳MRI检查技术。方法 回顾性分析2019年9月~2022年7月就诊于首都医科大学附属北京同仁医院的单侧听神经瘤患者的MRI资料,共39例。选择耳蜗为研究对象,由两名放射科医师共同进行患侧与健侧的耳蜗信号定性评估与定量测量,统计病变大小及位置,分别计算患侧与健侧的耳蜗信号强度/脑干信号强度的比值,采用独立样本t检验进行分析,判断患侧与健侧耳蜗信号强度/脑干信号强度比值是否具有统计学差异。同时采用受试者工作特征(ROC)曲线评估在各序列在判断耳蜗信号强度变化的诊断效能。结果 T1WI(20.5%)、增强T1WI(30.8%)、T2WI(15.4%)及增强延迟3D-T2 FLAIR(100%)显示患侧耳蜗信号相对健侧为高信号,水成像(83.3%)显示患侧耳蜗相对健侧为低信号。除T2WI序列外,患侧与健侧的耳蜗/脑干信号强度比值在其他各序列均存在统计学差异(P<0.05),增强延迟3D-T2 FLAIR的曲线下面积(AUC=0.822)最高,其次为水成像。结论增强延迟3D-T2 FLAIR在反映听神经瘤患者耳蜗信号变化更具优势,水成像同样也是必不可少的检查手段,为揭示听神经瘤引起迷路成分的病理生理改变提供新的无创检查方法。OBJECTIVE To compare the effectiveness of multiparameter MRI in demonstrating labyrinth signal changes in patients with acoustic neuroma,and to find the best MRI examination path for displaying labyrinth signal changes.METHODS 39 patients with unilateral acoustic neuroma in Beijing Tongren Hospital from September 2019 to July 2022 were analyzed retrospectively.The cochlea was selected as the research object.Two radiologists performed cochlear signal evaluation and quantitative measurement on the diseased side and the healthy side,counted the size and location of the lesions,calculated the ratio of cochlear signal intensity/brainstem signal intensity on the diseased side and the healthy side respectively.The independent sample t-test was used to determine whether the ratio of cochlear signal intensity/brainstem signal intensity between the affected side and the healthy side was statistically different.The ROC curve was used to evaluate the diagnostic efficacy of each sequence in reflecting the change of cochlear signal intensity.RESULTSThe cochlear showed higher signal intensity in the diseased side compared with the healthy side on T1WI(20.5%),post-contrast T1WI(30.8%),T2WI(15.4%) and enhanced delayed 3D-T2 FLAIR(100%),but the cochlear showed lower signal intensity on hydrography(83.3%).The cochlear/brainstem signal intensity ratio between the diseased side and the healthy side was statistically different(P<0.05) except for T2WI.The area under the curve(AUC) of enhanced delayed 3D-T2 FLAIR was the highest,followed by hydrography.CONCLUSION Enhanced delayed 3D-T2FLAIR has more advantages in reflecting cochlear signal changes in patients with acoustic neuroma.Hydrography is also an indispensable means,providing a new non-invasive examination method for revealing pathological changes of labyrinth components caused by acoustic neuroma.

关 键 词：磁共振成像 耳蜗 听神经瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]