贝尔面瘫的MRI表现及术中对照研究

Investigation of MRI Findings in Bell's Palsy Correlated with Operative Results

目的探讨贝尔面瘫的MRI表现及诊断价值。资料与方法回顾性分析14例贝尔面瘫患者的MRI表现,并就其中8例与术中所见对照。结果 71%(10/14)患侧面神经内耳道底段强化,93%(13/14)患侧面神经迷路段强化,而健侧面神经未见此两段强化;93%(13/14)患侧面神经膝状神经节强化,43%(6/14)健侧面神经膝状神经节强化;43%(6/14)患侧面神经鼓室段强化,21%(3/14)健侧面神经鼓室段强化;79%(11/14)患侧面神经乳突段强化,71%(10/14)健侧面神经该段强化。手术8例中不同节段神经肿胀范围与MRI增强表现符合率较高。结论贝尔面瘫患者内耳道底段及迷路段的明显强化具有一定特异性和敏感性,而乳突段强化特异性最差。MR增强扫描能够客观地反映面神经的病变范围,有助于临床诊断及鉴别诊断,并且可以为面神经减压术提供重要信息。

Objective To investigate the MR findings and its diagnostic value in bell＇s palsy.Materials and Methods MRI findings of 14 patients with bell＇s palsy were analyzed retrospectively.8 cases were compared with the operative findings.Results intrameatal and labyrinthine segments of the normal facial nerves were not enhanced,whereas enhancement of distal intrameatal and labyrinthine segments were respectively found in 71%（10/14） and 93%（13/14） of affected facial nerves.The geniculate ganglions were enhanced in 93%（13/14） affected facial nerves versus 29%（4/14）in normal facial nerves.The tympanic segments were enhanced in 43%（6/14） affected facial nerves versus 1%（1/14）in normal facial nerves.The mastoid segments were enhanced in 79%（11/14） affected facial nerves versus 71%（10/14）in normal facial nerves.MRI enhanced findings were corresponded with edema of the paralytic facial nerves in operations.Conclusion Enhancement of distal intrameatal and labyrinthine segments is specific and sensitive in the diagnosis of Bell＇s palsy,while,the enhancement of mastoid segments is nonspecific.Enhanced MRI can demonstrate the extent of lesion objectively,which may be helpful in the diagnosis and differential diagnosis of Bell＇s palsy and provide important information for facial nerve decompression.