1.5T MRI常规序列及水成像用于儿童内耳畸形的诊断价值

Diagnostic value of 1.5 T MRI and conventional sequences hydrography for inner ear deformity in children

目的探讨MRI在儿童内耳畸形中的应用价值。方法选择2013年7月至2015年12月在深圳市龙华新区人民医院和北京大学深圳医院诊治的疑似内耳畸形患儿30例（60耳）,其中男性13例,女性17例;年龄1-14岁,平均年龄9岁。选择6例内耳正常志愿者（对照组）,其中男性3例,女性3例;年龄1-16岁,平均年龄10岁。采用Philips Achieva 1.5 T MRI扫描仪对临床拟诊为感音性神经性耳聋（SNHL）患儿进行蜗神经MRI成像和内耳水成像,正常志愿者进行MRI对照检查。结果 30例患儿中,内耳重型畸形9例（30%）（Michel畸形4例7耳,Mondini畸形2例4耳,蜗神经缺如3例5耳）;内耳相对轻型畸形21例（70%）（共腔畸形2例4耳,蜗管发育不全性聋2例4耳,Scheibe型畸形5例10耳,前庭导水管扩大10例19耳,内听道畸形而耳蜗及蜗神经发育正常或不良2例3耳）。其中含有3例两组交叉复合畸形即左右耳分别为重型和相对轻型内耳畸形。结论 MRI较为准确判断患儿内耳畸形、蜗神经发育状况,并可对畸形轻重程度分类,可为人工耳蜗植入适应证与禁忌证提供影像证据,在诊断SNHL中发挥着重要价值。

Objective To study the application value of magnetic resonance imaging（MRI） for children with inner ear malformation. Methods From July 2013 to December 2015, a total of 30 cases suspected with inner ear deformity in Shenzhen Longhua New District People＇s Hospital and Peking University Shenzhen Hospital were enrolled, which included 13 males and 17 females, aged 1-14 years old with mean age of 9 years old. Six inner ear normal volunteers were set as control group, which included 3 males and 3 females, aged 1-16 years old with mean age of 10 years old. The Philips Achieva 1.5 T MRI scanner was used to detect MRI and hydrography for patients with sensorineural hearing loss（SNHL）, and normal volunteers were performed MRI as control detection. Results In 30 cases, 9 cases（30 %） of inner ear severe deformity, which included 7 ears of Michel deformity in 4 cases, 4 ears of Mondini deformity in 2 cases and 5 ears of cochlear nerve agenesis in 3 ears; The inner ear was relatively slight deformity in 21 cases（70 %）, which include 4 ears of cavity deformity in 2 cases, 4 ears of scroll hypoplasia deafness in 2 cases, 10 ears of scheibe malformation in 5 cases, 19 ears of vestibular aqueduct in 10 cases and 3 ears of internal auditory canal malformation with cochlea and cochlear nerve normal or dysplasia. Three in these 30 cases were cross-multiple deformities in 2 groups, which were severe and relatively slight deformity in different inner ear. Conclusion It is demonstrated that MRI could determine the growth of inner ear deformity and cochlear nerve accurately, which classify deformity severity and provide imaging evidence for indications and contraindications in cochlear implatation, so it is plays important value in diagnosis of SNHL.