不完全分隔Ⅱ型内耳畸形患者影像学特征分析

Imaging Features in Patients with Type IP-ⅡInner Ear Malformation

目的探讨不完全分隔Ⅱ型内耳畸形患者的影像学基本数据特征,为更好地认识该类畸形提供依据和临床指导。方法将2020年1月—2021年12月新疆维吾尔自治区人民医院筛查的重度-极重度感音神经性耳聋患者根据Sennaroglu的分类方法,所有患者分为试验组(IP-Ⅱ)24例、对照1组(单纯前庭导水管扩大)15例、对照二组(内耳畸形)28例,对颞骨HRCT及内耳MRI进行图像后期处理,并完成各指标的测量,包括耳蜗高度、前庭长径、前庭宽径、前庭导水管外口宽度等,应用单因素方差分析比较3组间的各个指标的差异。结果3组耳蜗高度、耳蜗底周长度、耳蜗底周管径、蜗孔宽度、前庭长径、前庭宽径组间差异有统计学意义(P<0.05)。不完全分隔试验组和对照一组的前庭导水管外口宽度、前庭导水管中段宽度、内淋巴囊长度、宽度比较,差异无统计学意义(P>0.05)。结论不完全分隔IP-Ⅱ型影像学典型特征为耳蜗中周、顶周融合,伴前庭、前庭导水管扩大,以及内淋巴管、内淋巴囊扩大,本资料相关数据的测量对于认识IP-Ⅱ型内耳畸形具有重要的临床意义。

Objective To report imaging characteristics in patients with IP-Ⅱinner ear malformation in order to provide a basis and guidance for better understanding of this malformation.Methods Children with severe to profound sensorineural hearing loss screened from January 2020 to December 2021 were divided into IP-Ⅱ(24 cases),simple enlarged vestibular acqueduct(EVA)(15 cases)and malformation free(28 cases)groups based on strict inclusion criteria and the Sennaroglu's classification.Temporal bone HRCT and inner ear MRI image post-processing were performed to measure indicators including cochlear height and vestibular aqueduct(VA)size.One-way analysis of variance was used to compare each indicator among the three groups.Results There were statistically significant differences in cochlear height,length of cochlear basal turn,diameter of cochlear basal turn,width of cochlear aperture,vestibular length,vestibular width,operculum diameter of VA and midpoint diameter of VA among the three groups(P<0.05).No statistically significant difference was found in operculum diameter of VA,midpoint diameter of VA,the length and width of the endolymph sac between the IP-Ⅱgroup and the EVA group.Conclusion The typical imaging feature of IP-ⅡI is fusion of the middle and apical cochlear turns,accompanied by enlargement of vestibule and vestibular aqueducts,as well as enlargement of the endolymphatic duct and endolymphatic sac.These data have important clinical significance for cognizing the IP-Ⅱinner ear malformation.