感觉神经性耳聋 MRI 495 例分析

MRI INVESTIGATION OF 495 PATIENTS WITH SENSORINEURAL HEARING LOSS

目的：探讨感觉神经性耳聋（ＳＮＨＬ）的各种病因及磁共振成像（ＭＲＩ）检查方法。方法：用ＳＥ和ＦＳＥ序列对４９５例临床诊断为ＳＮＨＬ患者进行ＭＲＩ检查。结果：ＭＲＩ发现颅内病变２１１例（４２６％），其中９５例（１９２％）病变位于听觉传导通路上，为ＳＮＨＬ的病因。１１例内耳区病变为感觉性耳聋，另外８４例听神经或脑内听觉传导纤维受损为神经性耳聋。８４例中６２例病变位于内听道和桥小脑角区，脑内病变为２２例。结论：ＳＮＨＬ患者ＭＲＩ检查应包括从耳蜗到颞横回的全部听觉传导通路。肿瘤、梗塞软化、多发硬化、炎症、迂曲血管和囊肿都可引起ＳＮＨＬ。

Objective:To investigate the causes of sensorineural hearing loss(SNHL) and the methodology of magnetic resonance imaging(MRI).Methods:495 consecutive patients with SNHL clinically diagnosed by SE and FSE were examined with MRI.Results:An intracranial abnormality was found in 211(42 6%) of the patients,and of them,95(19 2%) were along the acoustic pathway.11 of the 95 patients had sensory hearing loss while 84 had neural hearing loss with the retrocochlear auditory pathway affected by lesions.In 62 of the 84 patients,the internal acoustic canal and cerebellopontine angle were involved.22 patients had intra axial lesions.Conclusion:In a patient with SNHL,MRI must cover the entire acoustic pathway from the cochlea to the temporal gyrus.Tumor,infarction,traumatic necrosis,multiple sclerosis,cyst,inflammation and ectopic vessel are responsible for SNHL.