单侧突发性耳聋内耳MR水成像形态及信号分析

The Characteristics of Morphology and Signal of the Inner Ear Using MR Water Imaging Technique in Unilateral Sudden Hearing Loss

目的探讨单侧突发性耳聋患者内耳MR水成像的形态与信号特点。方法采用MR水成像技术检查63例单侧突发性耳聋患者的双侧内耳,观察耳蜗、前庭及3个半规管的形态;同时测量内耳迷路及同侧桥小脑角区脑脊液的信号强度,用SPSS 17.0软件行配对t检验,比较突发性耳聋患者患耳迷路信号与健耳的差异。结果63例126只内耳迷路成像良好,耳蜗及前庭无阳性表现,但10只(15.87%)患耳的多个半规管显影中断(5个外半规管、4个上半规管及1例后半规管)、边缘毛糙(1个外半规管及1个上半规管),3例(4.76%)健耳的3个半规管(2个外半规管、1个上半规管)显影中断。患耳形态学改变的阳性发生率较健侧高,χ2检验二者差异有统计学意义(P=0.041)。患侧内耳迷路与脑脊液信号强度比为1.02±0.198,健侧为1.09±0.198,患侧内耳迷路信号减低,配对t检验二者差异有统计学意义(P=0.024)。结论单侧突发性耳聋患者患耳除半规管毛糙和显影中断外,亦见迷路信号强度减低,提示突发性耳聋患者患耳迷路淋巴液成分发生了变化。

Objective To analyze the morphology and signal features of inner ear using MR water imaging technique in unilateral sudden hearing loss. Methods MR water imaging technique was performed in 63 cases with unilateral sudden hearing loss. The morphology of cochlear, vestibule and three semicircular canals were observed. The signal intensity of the labyrinth and the same side eerebrospinal fluid were measured, at the same time, the signal intensity of the illed ear and the controlled one were compared. The paired t test was used for the statistics. Results All the structures of inner ears could be visualized clearly in 63 cases（ 126 ears）. There was no positive change on vestibule and cochlear. Several semicircular canals in 10 cases（ 15.87% ）of the illed ears and in 3 cases（4.76% ）of the controlled ears had positive changes. 5 lateral semicircular canals ,4 superior semicircular canals, 1 posterior semicircular canals of the illed ears and 2 lateral semicircular canals, 1 superior semicircular canals of the controlled ears were discontinue. 1 lateral semicircular canals, 1 superior semi- circular canals of the illed ears were coarse. There was a significant difference of morphology changes between the illed ear and the controlled one（ P = 0.041 ） . The ratio of the signal intensity in labyrinth and cerebrospinal fluid was 1.02 ＋ 0. 198 （illd ear）andl. 09 ~ 0. 198 （controlled ear）respectively. The signal intensity of the labyrinth on the illed side weakened, there was a significant difference of the signal intensity ratio between the illed ear and the controlled one （ P = 0. 024 ）. Conclusion Besides the semicircular canals were coarse and discontinue on unilateral sudden hearing loss, the signal in- tensity of the labyrinth on the illed side weakened. All these characteristics may reflect the changes in components of lym- pha fluid on sudden hearing loss.