MR内耳水成像技术在人工耳蜗植入术中的应用价值

Evaluation of cochlear implantation by magnetic resonance hydrography of inner ear

目的探讨MR内耳水成像技术在人工耳蜗植入术中的应用价值.方法 回顾性分析2015年4月-2016年3月在黑龙江省医院和哈尔滨医科大学附属第四医院行人工耳蜗植入术的128例患者的影像资料,其中男68例、女60例,年龄4-48岁,右耳植入101例、左耳植入27例.患者术前、术后均行头颅内听道螺旋CT及MR内耳水成像检查,并比较两种检测方法对患者内耳、中耳畸形及病变的检出率.结果 MR内耳水成像内听道总体异常检出率90.63%（116/128）,CT检出率为76.56%（98/128）,二者比较差异有统计学意义（χ2=9.228,P〈0.05）.在前庭导水管异常、耳蜗畸形、内听道狭窄、耳蜗纤维化等疾病,MR诊断的灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于CT,但差异均无统计学意义（P值均〉0.05）.结论 在人工耳蜗植入术前、术后进行MR内耳水成像技术检查,可有效了解患者内听道解剖学信息,对治疗方案的选择具有指导性意义,值得临床进一步推广应用.

Objective To evaluate the value of magnetic resonance imaging and spiral CT in detecting water ear cochlear implantation.Methods The MRI and CT data of 128 patients in line of cochlear implants from April 2015 to March 2016 were reviewed.Among them, there were 68 males and 60 females, age 4-48 years old.Cohlear implantation was performed in the right ear for 101 patietns and left ear for 27 patients.Preoperative and postoperative patients enrolled within the cranial auditory canal spiral CT and MRI, respectively, and to compare the detection rate of the patient＆#39;＆#39;s inner ear and middle ear deformity and lesion by the two methods.Results The detection rate of inner ear of MRI was 90.63% （116/128）, and the detection rate of CT abnormality was 76.56% （98/128）, the difference between the two groups was statistically significant （χ2 =9.228, P〈0.05）.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MR diagnosis in the vestibular aqueduct abnormalities, cochlear deformity, internal auditory canal stenosis, cochlear fibrosis, and so on were higher than those of CT, but they were not statistically significant （all P values〉0.05）.Conclusions Before cochlear implant surgery patients after MRI imaging techniques to check the water, which can effectively understand the patient eardrum, hearing anatomical information on treatment options guiding significance worthy of further promoting the use of clinical.