单侧感音神经性耳聋患者听觉传导通路变化的fMRI研究

The fMRI Study of Auditory Pathways Reorganization in Unilateral Sensorineural Hearing Loss

目的探讨正常听力者与单侧感音神经性耳聋患者听觉传导通路的异同,研究感音神经性耳聋后听觉传导通路的功能重组。资料与方法给予30名正常听力者、13例单侧右耳聋患者及10例单侧左耳聋患者500 Hz的纯音刺激,分别采集自旋回波(SE)T1WI横断面、梯度回复回波-回波平面成像(GRE-EPI)MR功能影像以及3D GRET1WI影像。图像经AFNI软件进行后处理,激活范围为半径5 mm,体积为300 mm3的连续激活区域为有意义激活区。结果正常听力者的听觉皮层、内侧膝状体及下丘核团对侧均大于同侧,为对侧优势。单侧耳聋患者内侧膝状体、下丘激活强度对侧大于同侧,仍保持对侧优势,而听觉皮层为同侧优势。结论正常听力者听觉传导通路表现为对侧优势,单侧感音神经性耳聋患者听觉传导通路发生结构与功能的重组,并且重组发生于听觉皮层水平。

Objective To observe the difference of auditory pathways between normal hearing subjects and unilateral sensorineural hearing loss（USNHL）patients and to study the reorganization of functional auditory pathways in USNHL.Materials and Methods Thirty nirmal hearing subjects,13 right USNHL patients and 10 left USNHL patients underwent MR imaging including T1WI,GRE EPI fMRI and 3D GRE T1WI at stimulation of 500 Hz pure-sound.All images were dealed with AFNI.The activation areas were considered as 5 mm radius and 300 mm3 continuous stimulating areas when.Results The stimulating strength of auditory cortex（AC）,medial geniculate body（MGB） and inferior colliculus（IC） in the opposite side were higher than that in the ipsilateral side,that was contralateral dominance in normal hearing subjects.It was contralateral dominance in MGB and IC but ipsilateral dominance in AC in USNHL patients.Conclusion The normal hearing subjects showed contralateral dominance of auditory pathways.But USNHL patients showed auditory pathways reorganization at cortical levels.