基于三维准连续动脉自旋标记成像评估单侧突发感觉神经性耳聋患者脑血流灌注改变  

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

作　　者：李海梅[1] 桑春玉[1] 陈悦 杨奡偲 马国林[2] LI Haimei;SANG Chunyu;CHEN Yue;YANG Aocai;MA Guolin(Department of Radiology,the Affiliated Fu Xing Hospital of Capital Medical University,Beijing 100038,China;Department of Radiology,China-Japan Friendship Hospital,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：《中国医学影像技术》2023年第2期276-280,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金项目(81971585)。

摘　　要：目的基于三维准连续动脉自旋标记成像(3D pCASL)评估单侧突发感觉神经性耳聋(SSNHL)患者脑血流灌注改变。方法对34例临床诊断单侧SSNHL患者(SSNHL组)和33名年龄、性别及受教育年限与之匹配的健康对照者(HC组)行3D pCASL扫描;评估SSNHL组平均听力阈值(PTA),以中文版耳鸣残疾量表(THI)、耳鸣评价量表(TEQ)、耳鸣响度视觉模拟评分法(VAS)、抑郁自评量表(SDS)及焦虑自评量表(SAS)观察其心理声学特征及情绪状况;基于体素水平分析组间脑血流量(CBF)存在差异的脑区,提取其空间标准化及归一化后的相对CBF(rCBF),分析SSNHL组异常灌注脑区rCBF与THI、TEQ、VAS、SDS及SAS评分的相关性。结果与HC组相比,SSNHL组右侧三角部额下回及后扣带回CBF增高,左侧楔前叶、双侧中央后回、右侧额中回及右侧顶上小叶CBF减低(P均<0.05)。SSNHL组左侧楔前叶及左侧中央后回rCBF与SDS评分呈负相关(r=-0.441、-0.437,P=0.015、0.016);SSNHL组异常灌注脑区的rCBF与其余量表评分均无明显相关(P均>0.05)。结论单侧SSNHL患者右侧额叶、双侧顶叶及后扣带回等多个脑区存在灌注改变。Objective To evaluate the changes of cerebral blood flow perfusion in patients with unilateral sudden sensorineural hearing loss(SSNHL)based on three dimensional pseudo-continuous arterial spin labeling imaging(3D pCASL).Methods Thirty-four patients with clinical diagnosed unilateral SSNHL(SSNHL group)and 33 age-,sex-and education level-matched healthy controls(HC group)were enrolled,and 3D pCASL scan was performed.The pure tone average(PTA)of SSNHL group was evaluated,and the psychoacoustic characteristics and emotional condition of SSNHL patients were observed using tinnitus handicap inventory(THI),tinnitus evaluation questionnaire(TEQ),visual analogue scale(VAS)of tinnitus volume,self-rating depression scale(SDS)and self-rating anxiety scale(SAS).The brain regions with significant differences of cerebral blood flow(CBF)between groups were analyzed based on voxel level analysis.Then the space standardized and normalized relative CBF(rCBF)were extracted to explore the correlations of rCBF of brain regions with abnormal perfusion with THI,TEQ,VAS,SDS and SAS scores in SSNHL group.Results Compared with HC group,CBF of right inferior frontal gyrus triangular part and posterior cingulate increased,while of left precuneus,bilateral postcentral gyrus,right middle frontal gyrus and right superior parietal lobule decreased in SSNHL group(all P<0.05).In SSNHL group,rCBF of left precuneus and left postcentral gyrus were negatively correlated with SDS scores(r=-0.441,-0.437,P=0.015,0.016).rCBF of abnormal perfusion brain areas in SSNHL group were not obviously correlated with the other scores(all P>0.05).Conclusion Unilateral SSNHL patients had perfusion changes in multiple brain regions,including the right frontal lobe,bilateral parietal lobes and posterior cingulate gyrus.

关 键 词：耳聋 感觉神经性 脑血管循环 磁共振成像 动脉自旋标记 

分 类 号：R764.45[医药卫生—耳鼻咽喉科] R445.2[医药卫生—临床医学]