基于MR神经成像定量评估周围性面瘫患者面神经及周围淋巴结  

The value of MR neuroimaging in image evaluation of facial neuritis

作　　者：刘丽华[1] 黄慧敏 冀晓东[1] 王巍[3] 胡明[3] LIU Lihua;HUANG Huimin;JI Xiaodong;WANG Wei;HU Ming(Department of Radiology,Tianjin 1st Central Hospital,Tianjin,300192,China;Department of Radiology,Huang He Hospital;Department of Radiology,Tianjin 1st Central Hospital)

机构地区：[1]天津市第一中心医院放射科,天津300192 [2]天津市黄河医院放射科 [3]天津市第一中心医院耳鼻咽喉头颈外科,天津市耳鼻喉科研究所,天津市听觉言语与平衡医学重点实验室,天津市医学重点学科

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第1期29-33,41,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：天津市卫生健康科技项目(No:ZC20061);天津市医学重点学科建设项目(No:TJYXZDXK-046A);天津市应用基础多元投入项目(No:21JCYBJC01790)。

摘　　要：目的:探讨MR神经成像定量评估急性周围性面瘫患者面神经及周围淋巴结的价值。方法:采用前瞻性实验设计,纳入32例急性周围性面瘫患者,基于MR神经成像技术采集双侧面神经MR高分辨薄层图像,测量双侧面神经不同节段(包括迷路段、膝状神经节、水平段、垂直段、茎乳孔段、腮腺段主干、颞面干、颈面干)直径以及耳周、腮腺淋巴结的定量指标(数量、最大淋巴结的长短径)。采用配对t检验及Wilcoxon符号秩检验,比较双侧面神经直径、周围淋巴结定量指标差异。结果:面瘫侧膝状神经节、茎乳孔段、腮腺段主干、颞面干、颈面干直径明显大于健侧(均P<0.05),但迷路段、水平段、垂直段直径与健侧比较差异无统计学意义;面瘫侧耳周淋巴结的数量明显多于健侧(P=0.001)。结论:MR神经成像可定量评估急性周围性面瘫患者面神经结构变化:膝状神经节、茎乳孔段、腮腺段主干、颞面干及颈面干增粗;同时发现患侧耳周淋巴结数量增多。上述发现可辅助评估疗效、判断预后。Objective:To exploring the value of MR neuroimaging for quantitative assessment of the facial nerve and peripheral lymph nodes in patients with acute peripheral facial paralysis.Methods:Based on a prospective experimental design,32 patients with idiopathic peripheral facial palsy were enrolled in the experiment.Based on MR neuroimaging technology,MR high-resolution thin-layer images of bilateral facial nerves were acquired.The diameters of different segments of the bilateral facial nerve were measured,including the labyrinthine segment,the geniculate ganglion,the horizontal segment,the vertical segment,the stem-mammary foramen segment,the trunk of the parotid segment,the temporal trunk,and the cervical trunk,as well as the quantitative indicators of peri-auricular and parotid lymph nodes(number,length and diameter of the largest lymph nodes).Differences in quantitative indices of nerve diameter and peripheral lymph nodes between the paraplegic and healthy sides were compared using the paired t-test and Wilcoxon signed rank test.Results:The diameter of geniculate ganglion,mastoid foramen stem,parotid main trunk,temporal facial trunk,and cervical facial trunk were notably increased on the facial paralysis side compared to the contralateral side(P<0.05).However,no significant differences were observed in the diameter of labyrinthine segment,horizontal segment,or vertical segment compared to the contralateral side.There were significantly more periauricular lymph nodes on the facial paralysis side than the contralateral side(P=0.001).Conclusion:MR neuroimaging enables the quantitative assessment of structural changes in the facial nerve of patients with acute peripheral facial paralysis,demonstrating nerve enlargement in the geniculate ganglion,stylomastoid foramen segment,main trunk of the parotid segment,temporal facial trunk,and cervical facial trunk.Additionally,an increased number of periauricular lymph nodes is observed on the affected side.These findings may aid clinicians in assessing the efficacy of treatmen

关 键 词：急性周围性面瘫 BELL面瘫 Hunt综合征 MR神经成像 面神经 

分 类 号：R745.1[医药卫生—神经病学与精神病学]