听性脑干反应在听神经瘤诊断上的应用

Auditory brainstem response in diagnosis of acoustic meuroma

目的 探讨听性脑干反应 (ABR)在听神经瘤诊断上的实际应用价值。方法 回顾性分析 10 5例经手术证实为听神经瘤患者ABR的各项指标 ,以及它与肿瘤体积大小的关系。结果 听神经瘤直径≥ 1、<2cm时 ,ABRⅠ波到Ⅴ波的完全出现率为 10 0 % (2 2 / 2 2 ) ,其中Ⅰ、Ⅲ、Ⅴ的潜伏期均值分别为 1.6 8、4.19、6 .39ms;两耳V波的潜伏期差均值 (IT5 )为 0 .8ms ;Ⅰ波到Ⅴ波的波间期 (T5 - 1)为 4.71ms。在听神经瘤≥ 2cm、<4cm时 ,ABR的完全出现率为 38% (19/ 5 0 ) ,其中Ⅰ、Ⅲ、Ⅴ波的均值分别为 1.6 1、4.2 6、6 .5 2ms ;IT5为 0 .96ms ;T5 - 1为 4.91ms。在听神经瘤≥ 4cm时 ,ABR的完全出现率仅为 6 .1% (2 / 33) ,其中Ⅰ、Ⅲ、Ⅴ的均值为 1.47、4.79、7.12ms;IT5为 1.2 4ms;T5 - 1为 5 .6 5ms。结论 ABRⅠ波到Ⅴ波的完全出现率与肿瘤大小有关 ;ABRⅤ波的延长、IT5的增加、T5 - 1的延长既可作为听神经瘤早期诊断的依据之一 ,又可间接判断肿瘤瘤体的大小。

Objective To study the value of ABR in diagnosis of acoustic meuroma. Method Retrospective analysis of the relevant index of ABR in acoustic meuroma testified by 105 operations and assessed the relationship between the size of acoustic meuroma and ABR. Results When the acoustic meuroma reached the size of Φ ≥1, <2 cm, the appearance rate of ABR was 100% (22/22), the latent period of waves Ⅰ,Ⅲ,Ⅴ were 1.68、4.19、6.39 ms respectively; IT5 was 0.8 ms; and T5-1 was 4.71 ms. Acoustic meuroma Φ ≥2, <4 cm, the appearance rate of ABR was 38% (19/50), the latent period of waves Ⅰ,Ⅲ,Ⅴ were 1.61、4.26、6.25 ms respectively; IT5 was 0.96 ms; T5-1 was 4.91 ms. When the acoustic meuroma Φ ≥4 cm, the appearance rate of ABR was 6.1%(2/33), the latent period of waves Ⅰ,Ⅲ,Ⅴ were 1.47, 4.79, 7.12 ms respectively; IT5 was 1.24 ms and T5-1 was 5.65 ms. Conclusion The appearance rates of ABR Ⅰ-Ⅴ were related to the size of acoustic meuroma. The prolongation of ABR wave Ⅴ, IT5, T5-1 not only provided the basis for diagnosis of acoustic meuroma, but also could estimate the size of acoustic meuroma indirectly.(Shanghai Med J, 2000,23∶744-746)