MR增强扫描在Bell面瘫患者复查中的应用  

Application of Contrast-Enhanced MR Scanning in the Reexamination of Patients with Bells Palsy

作　　者：李华丽 刘德全 周旭峰 高志翔 何莎莎 LI Huali;LIU Dequan;ZHOU Xufeng(Department of MR,Luoyang Central Hospital Affiliated To Zhengzhou University,Luoyang,Henan Provence 471000,P.R.China,P.R.China)

机构地区：[1]郑州大学附属洛阳中心医院影像科MR室,洛阳471000 [2]郑州大学附属洛阳中心医院神经内科,洛阳471000

出　　处：《临床放射学杂志》2023年第6期920-924,共5页Journal of Clinical Radiology

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20200872)。

摘　　要：目的 纵向观察Bell面瘫患者面神经的MR强化特征变化与预后的关系。方法 本研究为纵向观察性研究,前瞻性连续纳入本院神经内科住院的26例临床诊断为单侧Bell面瘫的患者为研究对象,分别于发病3天内、1个月、3个月三次MR面神经增强扫描,根据3个月后患者面瘫恢复情况分为完全恢复组和不完全恢复组。每次MR检查对患者进行轴位T1WI三维磁化强度预备梯度回波序列(T1-3D-MP RAGE)增强扫描,把面神经分为用于评估强化程度的五个节段,并对各节段面神经强化程度进行1~3级的分级标识。结果 完全恢复组21例,不完全恢复组5例。发病3个月后不完全恢复组的内听道底段、迷路段、膝状神经节及鼓室段强化程度均高于完全恢复组,差异有统计学意义(P<0.05),而发病3天内和1个月后的内听道底段、迷路段、膝状神经节、鼓室段、乳突段及发病3个月后的乳突段强化程度均没有统计学差异(P>0.05)。结论 患侧面神经早期异常强化程度与患者最终预后无直接相关性,但是3个月后仍有多节段异常强化提示患者3月后甚至更远期的预后不良。Objective Longitudinal observation of the relationship between MR enhancement features and prognosis of facial nerve in patients with Bells palsy.Methods This study was a longitudinal observational study.26 patients with clinical diagnosis of unilateral Bells facial palsy who were hospitalized in our hospitals neurology department were prospec-tively and consecutively enrolled as the research object.Three MR enhanced scans were performed within 3 days,one month and three months after onset.According to the recovery of Bells palsy after three months,the patients were divided into com-plete recovery group and incomplete recovery group.Contrast-enhanced three-dimensional magnetization prepared rapid ac-quisition gradient echo sequence(T,-3D-MP RAGE)were performed on patients every time.The facial nerve was divided into five anatomical segments for the evaluation of the enhancement patterns,and the signal intensities of the enhanced facial nerves were graded from 1 to 3.Results The patients were categorized into a complete recovery group(n=21)and an incomplete recovery group(n=5).The enhancement degree of fundal canalicular,labyrinthine,geniculate ganglion and tympanic segment in the incomplete recovery group were higher than those in the complete recovery group after 3 months of onset(P<0.05).There was no significant difference of mastoid segment in the incomplete recovery group and complete re-covery group afer 3 months of onset(P>0.05).However,within 3 days and 1 month after the onset of the disease,there was no significant diference in the enhancement degree of five anatomical segments between the incomplete recovery group and the complete recovery group(P>0.05).Conclusion There is no direct correlation between the degree of abnormal enhancement of the paralyzed facial nerve at early onset and the patients final prognosis.However,there were still some seg-ments had abnormal enhancement after 3 months of onset indicating a poor prognosis for patients three months later or even longer.

关 键 词：BELL面瘫 面神经 磁共振成像 图像增强 

分 类 号：R445.2[医药卫生—影像医学与核医学] R745.12[医药卫生—诊断学]