迷路炎致单侧突发性聋患者MRI多序列分析  

Multi-Sequence Analysis of MRI in Patients with Unilateral Sudden Deafness Caused by Labyrinthitis

作　　者：王紫仪 林毅 杨本涛[3] WANG Ziyi;LIN Yi;YANG Bentao(Department of Radiology,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,P.R.China)

机构地区：[1]首都医科大学大兴教学医院放射科,北京102600 [2]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放射科,北京100730

出　　处：《临床放射学杂志》2022年第12期2176-2179,共4页Journal of Clinical Radiology

摘　　要：目的评价迷路炎所致单侧突发性聋患者MRI各序列迷路异常信号的显示能力,并探讨最佳阅片流程。方法回顾性分析2016年1月至2021年8月就诊于首都医科大学附属北京同仁医院及首都医科大学大兴教学医院70例单侧突发性聋患者的MRI资料,其中符合本研究入组标准总计42例患者(男20例,女22例),平均年龄(47.3±13.9)岁;由两名医师分别评估患者5个MRI序列平扫T_(1)WI、T_(2)WI、水成像(T_(2)-DRIVE-HR)、增强T_(1)WI及增强延迟三维液体衰减反转恢复(3D-FLAIR)显示迷路异常信号的效能,并对平扫T_(1)WI、增强T_(1)WI、增强延迟3D-FLAIR三个序列进行评分,采用Kappa检验对结果行一致性分析;采用Friedman检验对平扫T_(1)WI、增强T_(1)WI、增强延迟3D-FLAIR三个序列的主观评分行统计学分析。结果42例(100%,42/42)患侧迷路于增强T_(1)WI及增强延迟3D-FLAIR上均显示异常高信号,28例(66.7%,28/42)患侧迷路于平扫T_(1)WI上显示异常高信号,T_(2)WI显示低信号3例(7.1%,3/42),T_(2)-DRIVE-HR显示患侧低信号17例(40.5%,17/42),两名医师对平扫T_(1)WI、T_(2)WI、T_(2)-DRIVE-HR、增强T_(1)WI及增强延迟3D-FLAIR序列评估结果的Kappa系数分别为0.632、0.798、1.000、0.905、1.000;平扫T_(1)WI、增强T_(1)WI及增强延迟3D-FLAIR显示迷路异常高信号的能力评分中位数分别为2(2,3)、3(3,4)及4(4,4),两名医师对三个序列评分结果的Kappa系数分别为0.628、0.835、1.000,各序列总体评分有统计学差异(χ^(2)=72.641,P<0.001),且两两间比较均有统计学意义(P均<0.001)。结论对迷路炎所致突发性聋患者,平扫T_(1)WI、增强T_(1)WI能够发现迷路异常信号,但增强延迟3D-FLAIR相较于二者更敏感;T_(1)WI和3D-FLAIR结合有助于该病的精准诊断。Objective To evaluate the ability of magnetic resonance imaging(MRI)to display abnormal labyrinthine high signal on different sequence in patients with unilateral sudden deafness caused by labyrinthitis,and to explore the best process for reading images.Methods MRI data of 70 patients with unilateral sudden deafness attending to Beijing Tongren Hospital affiliated to Capital Medical University and Daxing Teaching Hospital of Capital Medical University from January 2016 to August 2021 were retrospectively analyzed,of which a total of 42 patients met the enrollment criteria of this study,including 20 males and 22 females,aged(47.3±13.9)years.Two physicians evaluated the efficacy of the patient’s 5 MRI sequences including plain T1-weighted image(T_(1)WI),T_(2)-weighted image(T_(2)WI),T_(2)-DRIVE hydrography(T_(2)-DRIVE-HR),enhanced T_(1)WI,and delayed enhanced 3 D-fluid attenuation inversion recovery(3 D-FLAIR),to show abnormal labyrinthine signal,and scored the plain T_(1)WI,enhanced T_(1)WI and 3 D-FLAIR sequences,the results were analyzed for consistency by Kappa test.The Friedman test was used to statistically analyze the subjective score of the 3 sequences.Results Forty-two patients showed abnormal labyrinthine high signal on enhanced T_(1)WI and 3 D-FLAIR(100%,42/42),28 showed abnormal labyrinthine high signal on plain T_(1)WI(66.7%,28/42),3 showed low signal on T_(2)WI(7.1%,3/42)and 17 showed low signal on T_(2)-DRIVE-HR(40.5%,17/42).The Kappa coefficients of the 2 physicians for evaluating results of the 3-sequence were 0.632,0.798,1.000,0.905,1.000;The score was 2(2,3),3(3,4)and 4(4,4)of T_(1)WI,enhanced T_(1)WI and 3 D-FLAIR,respectively,the Kappa coefficients of the 2 physicians for the 3-sequence scoring results were 0.628,0.835 and 1.000,respectively.The overall difference in scores of the sequences was statistically significant(χ^(2)=72.641,P<0.001),and both comparisons were statistically significant between the two(all P<0.001).Conclusion For the sudden deafness patients caused by labyrinthitis,pl

关 键 词：迷路炎 突发性聋 磁共振成像 

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