突发性聋患者内耳钆造影所见及临床分析

Gadolinium angiography of inner ear in patients with sudden deafness and its clinical analysis

目的:观察突发性聋患者内耳钆造影表现并分析其临床特征。方法:连续选择2017年11月至2020年7月就诊于鄂尔多斯市东胜区人民医院的21例突发性聋患者作为研究对象,其中男14例,女7例,年龄36~76岁,中位年龄50岁,病程1~19 d,平均5.5 d。患者分别进行听力学、静脉注射内耳钆造影(每例患者均进行2次磁共振3D-FLAIR序列扫描:静脉注射钆剂前扫描1次,注射钆剂后4.5~6.0 h再扫描1次)和实验室检查,并给予相应临床治疗。观察患者影像学表现及临床特征。结果:21例急性期突发性聋患者中,11例患耳MRI钆造影信号强度明显高于对侧耳,其中2例有前庭膜迷路积水;实验室相关检查仅2例全聋型患者血常规白细胞计数和红细胞沉降率加快,其余未见异常。21例突发性聋患者听力分型:全聋型8例,平坦下降型10例,低频下降型1例,高频下降型2例,治疗后总有效率为57%(12/21)。11例内耳钆造影异常患者的听力分型为全聋型5例,平坦下降型5例,高频下降型1例,治疗后总有效率为64%(7/11)。结论:部分突发性聋患者内耳钆造影异常,可能存在内耳血迷路屏障通透性增加,值得进一步研究探讨。

Objective To observe the gadolinium imaging findings of inner ear in patients with sudden deafness and to analyze its clinical features.Methods From November 2017 to July 2020,21 patients with sudden deafness in the People′s Hospital of Dongsheng District,Ordos City were selected as the research objects,including 14 males and 7 females,aged 36-76 years,with a median age of 50 years.The course of disease was 1-19 days,with an average of 5.5 days.The patients received audiology tests,laboratory examination,and intravenous gadolinium angiography,each of whom was scanned twice by 3D-FLAIR sequence:once before intravenous gadolinium injection,and once again 4.5-6.0 h after intravenous gadolinium injection.The following corresponding clinical treatment was given.The imaging manifestations and clinical features were observed.Results Among 21 cases of sudden deafness in acute stage,the signal intensity of 11 cases was significantly higher than that of the contralateral ear,and 2 cases had vestibular labyrinthine hydrops.In laboratory examination,only 2 cases of total deafness had increased WBC count and faster erythrocyte sedimentation rate,and the rest had no abnormality.The hearing types of 21 patients with sudden deafness were:total deafness in 8 cases,flat decline in 10 cases,low frequency decline in 1 case,high frequency decline in 2 cases.The total effective rate was 57%(12/21).The hearing types of 11 patients with abnormal gadolinium angiography were total deafness in 5 cases,flat decline in 5 cases and high frequency decline in 1 case.The total effective rate was 64%(7/11).Conclusion Gadolinium angiography is abnormal in some patients with sudden deafness,and the permeability of blood labyrinth barrier may be increased,which is worthy of further study.