血-迷路屏障通透性与突聋发病机制及预后的关系:在3D real IR的发现  

Relation of Blood-labyrinth Barrier Permeability to the Pathogenesis of Sudden Sensorineural Hearing Loss:Findings on Three-dimensional Real Inversion Recovery Imaging MRI

作　　者：张呈辉[1] 任芳芳[1] 王伟韬[1] 郝芳 冀少杰 Zhang Chenghui;Ren Fangfang;Wang Weitao;Hao Fang;Ji Shaojie(The Fifth Affiliated Hospital of Zhengzhou University,the Department of ENT,Zhengzhou,450052,China)

机构地区：[1]郑州大学第五附属医院耳鼻喉科,郑州450052

出　　处：《听力学及言语疾病杂志》2024年第3期236-240,共5页Journal of Audiology and Speech Pathology

基　　金：河南省重点研发与科技攻关项目(232102310164)。

摘　　要：目的分析突聋患者的内耳钆造影MRI三维真实重建反转恢复(three dimensional real inversion recovery,3D real IR)成像上的表现,探讨血-迷路屏障的通透性与突聋发病机制及其预后的关系。方法对41例单侧突聋患者行内耳钆造影MRI,测量患耳和健耳的耳蜗信号强度,并测量延髓信号强度,分别计算出耳蜗/延髓比值(cochlear/medulla ratio,CM ratio),以CM比值作为血-迷路屏障通透性的标志物,分析突聋患者患耳、健耳CM比值的不对称程度与疗效之间的关系。结果41例患者中,33例(80.48%)患耳的CM比值高于健耳,差异有统计学意义(P<0.05);患耳CM比值为健耳的1.5倍以下者18例,治疗有效率为77.78%(14/18);患侧CM比值不高于健侧者8例,治疗有效率为100%;达到健耳的1.5倍至1.75倍之间者7例,治疗有效率为100%(7/7);达到健耳的1.75倍至2.0倍之间者2例,治疗有效率为50%(1/2);达到健耳的2.0倍以上者14例,治疗有效率为14.28%(12/14);差异有统计学意义(P<0.05)。结论内耳3D Real IR可显示突聋患者血-迷路屏障通透性的改变,80.48%的突聋患者患侧耳蜗出现高信号,患耳CM比值达健耳的1.75倍以上者多数预后不良。Objective To study the inner ear appearance on three-dimensional real inversion recovery(3D real IR)imaging in patients with sudden sensorineural hearing loss,and to investigate the relationship between blood-labyrinth barrier permeability and pathogenesis and prognosis of sudden hearing loss.Methods A total of 41 patients with sudden sensorineural hearing loss received 3D real IR at 3.0 T MRI,and the signal intensity of inner ear were recorded.We respectively measured cochlear signal intensity in affected and healthy ears,and medullary signal intensity,and calculated the cochlear/medulla ratio(CM ratio)separately.On the basis of CM ratio,we evaluated hearing levels at initial and after treatment,and the relationship between CM ratio and hearing prognosis.Results Among the 41 patients,33 cases(occupying 80.48%)individually had a higher CM ratio in the affected ear than in the healthy one.The CM ratio of the affected side was not higher than that of the healthy side in 8 cases,and the effective rate was 100%,eighteen cases had below 1.5 times the CM ratio in affected ears as in healthy ears,with 77.78%effective rate of treatment;seven cases had 1.5 to 1.75 times,with 100%effective rate;two cases had 1.75 to 2 times,with 50%effective rate;and the rest 14 cases had over 2 times,with 14.28%effective rate(P<0.05).Conclusion The variation of blood-labyrinth barrier permeability in patients with sudden hearing loss can be read on the 3D Real IR,and it indicates that 80.48%patients have higher-intensity signals in lateral cochlea.The CM ratio can be adopted to evaluate the extent of inner ear damage of patients more accurately.As the CM ratio rises,patients'prognosis become worse,and patients with over 1.75 times the CM ratio in the affected ear as in the healthy one,mostly suffer poor prognosis.

关 键 词：突聋 血-迷路屏障通透性 内耳三维真实重建反转恢复成像 耳蜗/延髓比值 预后 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]