颞骨高分辨率CT半规管共脚内侧裂隙征对大前庭导水管综合征的诊断价值  

Diagnostic value of the temporal bone high-resolution CT semicircular canal common peduncle medial cleft sign in the diagnosis of enlarged vestibular aqueduct syndrome

作　　者：李莉[1,2] 赖艳梅 方哲明 Li Li;Lai Yanmei;Fang Zheming(Department of Imaging,National Regional Medical Center,Binhai Campus of First Affiliated Hospital,Fujian Medical University,Fuzhou 350212,China;Department of Medical Imaging,Dongying City People's Hospital,Dongying 257091,China)

机构地区：[1]福建医科大学附属第一医院滨海院区国家区域医疗中心影像科,福州350212 [2]东营市人民医院医学影像科,东营257091

出　　处：《中华解剖与临床杂志》2024年第8期533-537,共5页Chinese Journal of Anatomy and Clinics

摘　　要：目的:探讨颞骨高分辨率CT(HRCT)半规管共脚内侧裂隙征对大前庭导水管综合征(LVAS)的诊断价值。方法:横断面研究。纳入2006年1月—2023年3月福建医科大学附属第一医院先天性感音神经性耳聋患者832例,其中男526例、女306例,年龄0.25~39.00[2.67(1.50,5.71)]岁。所有患者均行内耳MR水成像及颞骨HRCT检查。观察项目:(1)观察先天性感音神经性耳聋患者中LVAS发病特征;(2)以内耳MR水成像见内淋巴囊扩大为LVAS诊断金标准,评价HRCT半规管共脚内侧裂隙征对LVAS的诊断效能。结果:(1)832例(1664侧)先天性感音神经性耳聋患者中,内耳MR水成像确诊为LVAS患者136例267侧(16.0%,267/1664),其中男84例165侧(61.8%,165/267)、年龄0.50~39.00[2.25(1.52,5.44)]岁,女52例102侧(38.2%,102/267)、年龄0.25~28.00[3.00(1.52,6.00)]岁;双侧发病131例(96.3%,131/136),单侧发病5例(3.7%,5/136)。(2)HRCT半规管共脚内侧裂隙征诊断LVAS阳性患者272侧、阴性1392侧;灵敏度为100%,特异度为99.6%,阳性预测值为98.2%,阴性预测值为100%。构建ROC曲线,AUC为0.998(95%CI:0.996~1.000,P<0.001)。结论:颞骨HRCT的半规管共脚内侧裂隙征对前庭导水管异常扩大有较高的临床诊断价值,是CT诊断LVAS的特异征象。Objective This study aimed to investigate the diagnostic value of high-resolution computed tomography(HRCT)of the temporal bone semicircular canal common peduncle medial cleft sign for large vestibular aqueduct syndrome(LVAS).Methods Cross-sectional study.A total of 832 patients with clinically confirmed congenital sensorineural deafness,including 526 males and 306 females,aged 0.25-39.00(2.67[1.50,5.71])years,were selected from the First Affiliated Hospital of Fujian Medical University from January 2006 to March 2023.All patients underwent MR water imaging of the inner ear and HRCT of the temporal bone.The observational items were as follows:(1)the pathogenesis of LVAS in patients with congenital sensorineural deafness;(2)the dilatation of the endolymphatic sac found in MR water imaging of the inner ear was used as the gold standard in the diagnosis of LVAS to evaluate the diagnostic efficacy of the semicircular canal common penduncle medial cleft sign in LVAS.Results(1)Of the 832 patients(1664 sides)with congenital sensorineural deafness,136(16.0%,267/1664 sides)were diagnosed with LVAS by inner ear MR imaging,including 84 males(61.8%,165/267 sides),aged 0.50-39.00(2.25[1.52,5.44])years,There were 52 females,102 sides(38.2%,102/267),aged 0.25-28.00(3.00[1.52,6.00])years,131 patients of bilateral disease(96.3%,131/136)and five patients of unilateral disease(3.7%,5/136).(2)A total of 272 LVAS-positive patients and 1392 LVAS-negative patients were diagnosed with semicircular canal common peduncle medial cleft sign by HRCT.The sensitivity,specificity,positive predictive value,and negative predictive value were 100%,99.6%,98.2%,and 100%,respectively.The ROC curve was constructed with AUC of 0.998(95%CI:0.996-1.000,P<0.001).Conclusion The temporal bone HRCT hemicranial common peduncle medial cleft sign has a high clinical diagnostic value for the abnormal enlargement of the vestibular aqueduct,which necessitates CT diagnosis of LVAS.

关 键 词：听觉丧失 感音神经性 半规管共脚内侧裂隙征 大前庭导水管综合征 高分辨率计算机体层成像 

分 类 号：R764[医药卫生—耳鼻咽喉科] R816.96[医药卫生—临床医学]