MRH在内耳成像及病变诊断中的应用研究

Application of magnetic resonance hydrography technique in imaging of inner ear and diagnosis of inner ear diseases

目的比较多平面重建(MPR)、最大密度投影(MIP)、容积再现(VR)三种磁共振水成像技术(MRH)后处理方法对内耳解剖结构的显示情况及对内耳病变的应用价值。方法选择40例健康成人及35例临床确诊为感音神经性耳聋(SNHL)的患者内耳行高分辨三维快速自旋回波T2加权序列(3DTSET2WI)横断面扫描,然后行双侧斜矢状面扫描。数据采集后利用ViewForum后处理软件行MPR、MIP、VR重建。观察不同后处理技术显示内耳的解剖结构,行各方法间的t检验。结果①40例80侧内耳均能清晰地显示耳蜗前庭神经、面神经、蜗神经及内耳的细微解剖结构;②VR、MIP测量前、水平、后半规管最大径及管径,蜗管管径及最大径差异有统计学意义(P=0.001,P=0.000);③MPR对显示CN、FN、SVN、IVN有明显优势;VR对耳蜗、V、PSC、SSC、HSC显示的评分均高于MIP及MPR。结论磁共振水成像后处理方法中MPR显示神经具有优势,VR在观察膜迷路形态方面更清晰。

Objective： To compare 3 kinds of post-processing methods of magnetic resonance hydrography （MRH） technology （MPR, MIP and VR） in the usage of inner ear. Materials and Methods： Thirty-five patients with sensorineural hearing loss （SNHL） and 40 controls were recruited. High-resolution three-dimensional turbo spin echo T2WI （3D TSE T2WI） axial scanning and bilateral oblique sagittal scanning were performed in each subject with the data transmitted to the workstation fbr reconstruction by ViewForum. The data of inner ear was compared among different reconstruction modalities. Results： （1） Subtle anatomical structures of cochleovestibular nerve, facial nerve, and inner ear could be clearly shown in 80 ears of 40 adults. （2） The height of semicircular canals and diameter of upper and lateral semicircular canals were different between VR and MIP （P=0.001, P-0.000）. （3） MPR was superior in displaying CN, FN, SVN and IVN： the scores of VR are higher than that of MPR and MIP in displaying the structure of V, PSC, SSC and HSC. Conclusion： Among the 3 methods of post- processing, MPR is the best to show the nerves of the labyrinth. VR is the best to display the details of inner ear diseases.