磁共振对感音神经性耳聋人工耳蜗术前诊断的价值

Magnetic Resonance Imaging in Preoperative Evaluation of Cochlear Implant Candidates with Sensorineural Hearing Loss

目的探讨磁共振在人工耳蜗术前内耳成像在儿童感音神经性耳聋(SNHL)中的应用价值。方法搜集80例SNHL患儿均需要人工耳蜗,用signa HDe 1.5 T超导磁共振仪,先进行脑MRI平扫,排除颅内有无其他异常,再进行3D/FLESTA轴位扫描及MYTOOLS、Batch.oblique的超薄斜矢壮处理,迷路病变采用MIP重建。结果80例75耳可显示听神经及迷路正常,5例10耳Mondini畸型;4例4耳Michel畸型;16例28耳表现为前庭导水管扩大;6例4耳显示内听道狭窄伴蜗神经变细,31例畸形中有12例20耳同时伴有耳蜗前庭神经信号不同程度的缺失、部分变细。结论 MRI内耳成像技术对诊断感音神经性耳聋有很高的价值,能显示患儿蜗神经、前庭上下神经、面神经及内耳迷路的发育,人工耳蜗置换术前MRI检查是必须的。

Objective To explore the application of MRI in pre-operative evaluation of cochlear implant candidates with sensorineural hearing loss. Methods Eighty patients with sensorineural hearing loss who needed cochlear implant were studied with signa HDe 1.5-T MRI. B TFE Slim oblique sagittal scan and 3D/FLESTA. MYTOOLS、Batch.oblique.axial scan were performed in these patients with conventional brain scan to exclude intracranial abnormalities while MIP reconstruction was applicated on labyrinth with lesions. Results MRI scan clearly showed the results of 75 ears of 80 cases with normal auditory nerve and labyrinth,10 ears of 5 cases with severe Mondini malformation, 4 ears of 4 cases with severe Michel malformation , 28 ears of 16 cases with enlarged vestibular aqueduct, 4 ears of 6 cases with auditory canal stenosis accompanied slimsy cochlear nerve,20 ears of 12 cases in 31 patients with malformation with vestibular cochlear nerve signals missing and small size of cochleovestibular nerve. Conclusions Inner ear MRI has a great value for diagnosis of pediatric SNHL. It clearly shows the development of cochlear nerve, vestibular nerve ,facial nerve, labyrinth.It is necessary to perform MRI before cochlear implant surgery.