老年前庭阵发症3D-CISS高分辨磁共振成像的临床分析  

Clinical analysis of 3D-CISS high-resolution magnetic resonance imaging of vestibular paroxysmia in the elderly

作　　者：陈振华 蔡刚[1] 曹志勇[2] 王天乐[3] 朱丽[3] 朱向阳[2] 邵良[2] CHEN Zhenhua;CAI Gang;CAO Zhiyong;WANG Tianle;ZHU Li;ZHU Xiangyang;SHAO Liang(Department of Neurosurgery,the Second Affiliated Hospital of Nantong University,Jiangsu,Nantong 226001,China;Department of Neurology,the Second Affiliated Hospital of Nantong University,Jiangsu,Nantong 226001,China;Department of Imaging,the Second Affiliated Hospital of Nantong University,Jiangsu,Nantong 226001,China)

机构地区：[1]南通大学第二附属医院神经外科,江苏南通226001 [2]南通大学第二附属医院神经内科,江苏南通226001 [3]南通大学第二附属医院影像科,江苏南通226001

出　　处：《中国医药科学》2025年第3期168-171,共4页China Medicine And Pharmacy

基　　金：江苏省卫生健康委科研项目(H2019057);南通大学临床医学专项项目(2022LY008);南通大学第二附属医院培育基金(YPYJJZD006)。

摘　　要：目的 比较老年与非老年前庭阵发症(VP)患者的小脑脑桥角(CPA)磁共振断层血管成像(MRTA)的异同。方法 收集南通大学第二附属医院2013年1月至2020年7月收治的244例VP患者的临床资料,其中130例年龄≥60岁的VP患者纳入老年组,114例年龄<60岁的VP患者纳入非老年组,比较两组CPA的MRTA,分析前庭蜗神经和血管交互压迫情况,同时比较两组患者眩晕残障量表(DHI)、Berg平衡量表(BBS)评分。结果 MRTA诊断VP的神经血管压迫(NVCC)的敏感度为100%,特异度为70.0%,两组患者NVCC类型比较,差异无统计学意义(P> 0.05);老年组患者中动脉粥样硬化的小脑前下动脉(AICA)为NVCC主要责任血管,而非老年组患者中结构发育异常的椎基底动脉(VBA)为NVCC主要责任血管,两组差异有统计学意义(P <0.05);老年组患者DHI评分高于非老年组,BBS评分低于非老年组,差异有统计学意义(P <0.05)。结论 老年VP患者以动脉粥样硬化的AICA压迫前庭蜗神经多见,而非老年VP患者以结构发育异常的VBA压迫前庭蜗神经多见;老年患者眩晕残障和平衡功能障碍程度更高。Objective To compare the similarities and differences of magnetic resonance tomography angiography(MRTA)of the cerebellopontine angle(CPA)in elderly and non-elderly patients with vestibular paroxysmia(VP).Methods The clinical data of 244 patients with VP admitted to the Second Affiliated Hospital of Nantong University from January 2013 to July 2020 were collected,of which 130 patients with VP aged≥60 years were included in the elderly group,and 114 patients with VP aged<60 years were included in the nonelderly group.The MRTA of the CPA of the two groups was compared to analyze the vestibulocochlear nerve and blood vessel cross-compression.Meanwhile,the dizziness handicap inventory(DHI)and Berg balance scale(BBS)scores of the two groups were also compared.Results The sensitivity of MRTA in diagnosing neurovascular cross-compression(NVCC)of VP was 100%and the specificity was 70.0%.There was no statistically significant difference in the comparison of the types of NVCC between the two groups of patients(P>0.05).The main responsible vessel for NVCC was the atherosclerotic anterior inferior cerebellar artery(AICA)in patients in the elderly group and the structurally abnormal vertebrobasilar artery(VBA)in patients in the non-elderly group,with a statistically significant difference between the two groups(P<0.05).The DHI score was higher and the BBS score was lower in patients in the elderly group than that in the non-elderly group,with statistically significant differences(P<0.05).Conclusion Compression of the vestibulocochlear nerve by atherosclerotic AICA is more common in elderly patients with VP,whereas compression of the vestibulocochlear nerve by structurally abnormal VBA is more common in non-elderly patients with VP. The degree of dizziness handicap and balance dysfunction is higher in elderly patients.

关 键 词：前庭阵发症 磁共振断层血管成像 神经血管压迫 眩晕 

分 类 号：R445.2[医药卫生—影像医学与核医学] R764.3[医药卫生—诊断学]