突发性耳聋患者磁共振下内耳与听觉中枢血供的研究

The Relationship Between the Sudden Deafness and the Blood Supply of Inner Ear and the Auditory Center

目的探讨突聋与内耳及听觉中枢血供的关系。方法突发性耳聋患者20例（共26耳）,健康对照者20例（共40耳）。所有受试者均经电测听力初诊和MRI检查,MRI序列包括弥散成像（DWI）、灌注成像（PWI）、血管成像（MRA）和内耳水成像（FIESTA）。结果①对照组20例中（共40耳）,常规MRI、DWI、PWI均表现为正常。FIESTA序列中,有5例（7耳）表现为听神经与小血管关系相贴近,未见明显听神经受压迂曲、变形。②所有病人常规扫描及DWI均呈正常表现,排除听觉中枢皮层梗塞和脑干梗塞。③突发性耳聋患者20例中（共26患耳）,其中8（8/20）例（共12耳）在FIESTA中表现为相应的听神经脑池内段与小血管关系密切,其中相靠近4耳,密切接触6耳,血管明显推移神经2耳。PWI显示有7（7/20）例病人出现颞叶脑局部血流量较对侧下降（12.5%-46.5%）,脑血容量正常。结论突发性耳聋与内耳及听觉中枢的血供关系密切,改善其血供有利于突发性耳聋的治疗。

Objective To investigate the relationship between the sudden deafness and the blood supply of inner ear and the auditory center. Methods Twenty cases of sudden deafness, including 11 men （16 ears） and 9 women （10 ears）, were examined by brainstem electric response audiometry （BERA） and magnetic resonance imaging （MRI）. Meanwhile, there were 20 healthy volunteers in this study. The mean age was 27 years. The sequences of MRI included Diffusion We.ighted Imaging（DWI）, Perfusion Weighted phy （MRA）, and The Fast Imaging Employing In the control group, the MRI appearance were Imaging （PWI）, Magnetic Resonance Angiogra- Steady-state-Acquisition （FIESTA）. Results ① normal in routine method, DWI and PWI, other wise, the 8th nerve was closed to small vessels in 5 cases （7 ears） in FIESTA, but the 8th nerve was not winding or deform. ②The routine method and DWI of patients were normal. ③ In the FIESTA sequence, 8 cases （ 12 ears） were displayed that the never is near to the small vessels in 4 eras, in other 6 ears, it got in touch with the small vessels, and the 8th nerve was pressed by the： small vessels in 2 ears. In PWI sequence, the regional cerebral flow （rCBF） of temporal lobe was declined in 7 cases （ the value is from 12.5% to 46.5%）, but the regional cerebral volume （rCBV） was normal. Conclusion The relationship between the sudden deafness and the internal ear and the auditory center blood was close, improves their blood to supply to be advantageous to the sudden deafness.