颞部MRI增强扫描及面神经曲面重建在Ramsay-Hunt综合征诊断中的应用  

Application of temporal enhanced MRI scanning and curved planar reformation of facial nerve in the diagnosis of Ramsay-Hunt syndrome

作　　者：杜伟 王亚蓉 董季平[3] 张巧莹 邬小平[3] DU Wei;WANG Yarong;DONG Jiping;ZHANG Qiaoying;WU Xiaoping(Xi'an Jiaotong University Health Science Center,Xi'an 710061,China;Department of Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Radiology,Xi'an Central Hospital,Xi'an 710004,China)

机构地区：[1]西安交通大学医学部,陕西西安710061 [2]西安交通大学第一附属医院影像科,陕西西安710061 [3]西安市中心医院放射科,陕西西安710004

出　　处：《实用放射学杂志》2023年第9期1405-1408,共4页Journal of Practical Radiology

基　　金：陕西省自然科学基础研究计划一般项目(青年)(2022JQ-933)。

摘　　要：目的 探讨 Ramsay-Hunt综合征(RHS)患者颞部 MRI 增强扫描及面神经曲面重建(CPR)的影像特征及其诊断价值.方法 对 26 例经临床综合诊断为 RHS的患者行颞部 MRI增强扫描及面神经CPR,观察外耳、面神经及其他多组颅神经信号变化特点,观测病变的范围、信号及受累情况;测量面神经与邻近颞叶信号强度比值(SIR).结果 26 例 RHS患者临床均表现为单侧受累,其中左侧受累 17 例、右侧受累 9 例;MRI增强扫描及面神经CPR显示面神经受累 26 例(面神经脑池段受累 4 例,内听道段受累26 例,迷路段受累 22 例,鼓室段受累 9 例,乳突段受累 14 例),听神经受累 3 例,迷走神经受累 2 例;外耳道、耳廓异常强化 26 例;颅内感染 1 例.患侧面神经、外耳 SIR高于健侧(P<0.05).结论 RHS的 MRI 影像特征为耳廓肿胀强化、1 组或多组颅神经线样增粗强化,MRI检查具有较高的诊断价值.Objective To investigate the imaging features and diagnostic value of temporal enhanced MRI scanning and curved planar reformation(CPR)of facial nerve in patients with Ramsay-Hunt syndrome(RHS).Methods A total of 26 patients who were clinically diagnosed with RHS underwent temporal enhanced MRI scanning and CPR of facial nerve.The signal changes of external ear,facial nerve and other groups of cranial nerve were observed,and the extent,signal and involvement of the lesions were observed,and the signal intensity ratio(SIR)between facial nerve and adjacent temporal lobe were also measured.Results All 26 patients with RHS showed unilateral involvement,including 17 cases on the left side and 9 cases on the right side.All 26 cases showed facial nerve involvement via enhanced MRI scanning and CPR of facial nerve(including 4 cases with cisternal segment of facial nerve,26 cases with internal auditory canal,22 cases with labyrinthine segment,9 cases with tympanic segment,14 cases with mastoid segment),and there were 3 cases with auditory nerve involvement,2 cases with vagus nerve involvement,26 cases with abnormal enhancement of external auditory canal and auricle,and 1 case with intracranial infection.The SIR of affected side facial nerve and external ear were significantly higher than those of healthy side(P<0.05).Conclusion MRI images of RHS are characterized by swelling and auricle and linear thickening enhancement of one or more groups of cranial nerves with high diagnostic value.

关 键 词：面神经 外耳 磁共振成像 RAMSAY-HUNT综合征 

分 类 号：Q429.7[生物学—神经生物学] R445.2[生物学—生理学] R745.12[医药卫生—影像医学与核医学]