三维液体衰减反转恢复序列磁共振成像在内耳疾病中的应用研究

Application of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging for the diagnosis of inner ear diseases

目的探讨三维液体衰减反转恢复序列磁共振成像(3D-FLAIR MRI)在内耳疾病诊断中的应用。方法选择我院52例内耳疾病患者作为研究对象,将其分为研究组(梅尼埃病患耳组、可疑梅尼埃病患耳组和突发性聋患耳组)和对照组(健侧耳组),对受试者进行耳蜗电图及内耳3D-FLAIR MRI扫描等相关检查,观察各组内耳3D-FLAIR MRI内淋巴显像与耳蜗电图关系。结果 3D-FLAIR MRI扫描可观察到梅尼埃病组、可疑梅尼埃病组、突聋组内淋巴积水程度患侧比健侧耳组严重,但梅尼埃病、可疑梅尼埃病及突发性聋的内淋巴积水程度差异无统计学意义。内淋巴积水诊断的阳性率3D-FLAIR MRI扫描高于耳蜗电图,尤其在可疑梅尼埃病的诊断中3DFLAIR MRI检查比耳蜗电图更具有优势,但尚不能认为3D-FLAIR MRI扫描可以取代耳蜗电图检查。结论三维液体衰减反转恢复序列磁共振成像在内耳疾病诊断中的应用效果显著,可以用于梅尼埃病、可疑梅尼埃病及突聋的辅助诊断,能有效提高内耳内淋巴积水的检出率。

Objective To explore the application effect of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging （3D-FLAIR MRI） in the diagnosis of inner ear diseases. Methods 52 patients （ 104 ears） with inner ear diseases attending our hospital were collected and divided into study group （94 ears） （ consisting of affected ears with Meniere＇ s disease, suspect Meniere＇ s disease and sudden hearing loss） and control group （20 ears） （ consisting of healthy ears of above-mentioned diseases）. Elctrocochleogrophy （ECochG） and 3D-FLAIR MRI of inner ear were performed to all patients. The relationships between endolymphatic imagines in 3D-FLAIR MRI and ECochG results were observed and analyzed. Results Endolymphatic hydrops in the ears of the study group was more serious than that of the control group, while their differences among the affected ears with Meniere＇ s disease, suspect Meniere＇ s disease and sudden hearing loss were statistically insignificant. The positive rate of endolymphatic hydrops by 3D-FLAIR MRI was higher than that by ECochG. 3D-FLAIR MRI had special advantages over ECochG in the diagnosis of endolymphatic hydrops in suspect Meniere＇ s disease. Nonetheless, 3D-FLAIR MRI could not replace ECochG for the diagnosis of endolymphatic hydrops. Conclusion With remarkable application effect, 3D-FLAIR MRI can be applied in the auxiliary diagnosis of Meniere＇ s disease, suspect Meniere＇ s disease and sudden hearing loss to improve the detection rate of endolymphatic hydrops.