三维快速液体衰减反转恢复序列(3D-FLAIR)在突发性耳聋临床诊断中的应用价值分析

Analysis of Application Value of Threedimensional Fluid-attenuated Inversion Recovery Sequence(3D-FLAIR)in the Clinical Diagnosis of Sudden Deafness

目的分析三维快速液体衰减反转恢复序列(3D-FLAIR)在突发性耳聋(SD)临床诊断中的应用价值。方法选取2022年5月-2023年5月我院收治的84例SD患者为研究对象,所有患者均接受3D-FLAIR检查及常规实验室检查[纯音听阈测试、耳蜗电图、前庭诱发肌源性电位(VEMP)等],依据3D-FLAIR检查结果分为内耳正常组和内耳异常组,其中内耳异常组包括内耳异常A组(血迷路屏障渗出)和内耳异常B组(血迷路屏障破坏),探究3D-FLAIR在SD临床诊断中的应用价值,并分析SD患者不同3D-FLAIR检查结果的听力损失情况、前庭功能损伤情况及疗效分布情况。结果耳蜗电图、VEMP及3D-FLAIR检查对SD患者内耳异常检查的阳性率差异有统计学意义(P<0.05),且3D-FLAIR检查的阳性率明显高于耳蜗电图、VEMP检查(P<0.05)。84例SD患者中,听力损失程度中以极重度听力损失为主(44例,占比52.38%),听力曲线类型中以全聋型为主(43例,占比51.19%);3D-FLAIR显示异常有78例,其中A组有12例(内耳异常A组),B组有66例(内耳异常B组);3组间听力损失程度分布差异无统计学意义(P>0.05),听力曲线类型分布差异有统计学意义(P<0.05)。84例SD患者中,VEMP显示异常有62例(73.81%),HIT显示异常有29例(34.52%),VAT显示异常60例(71.43%),冷热试验显示异常有54例(64.29%);3组间VEMP、VAT及冷热试验异常分布比较差异均有统计学意义(P<0.05)。84例SD患者中,痊愈12例(14.29%),显效19例(22.62%),有效20例(23.81%),无效33例(39.28%);3组间疗效分布差异有统计学意义(P<0.05)。结论3D-FLAIR有助于了解SD患者内耳病理状态,对内耳异常有更高检出率,可用于SD的辅助诊断以提高治疗方案的有效性。

Objective To analyze the application value of three-dimensional fluid-attenuated inversion recovery sequence(3D-FLAIR)in the clinical diagnosis of sudden deafness(SD).Methods 84 patients with SD admitted to our hospital from May 2022 to May 2023 were selected as the study subjects,and underwent 3D-FLAIR examination and routine laboratory examinations[pure tone threshold test,electrocochleogram,vestibular evoked myogenic potential(VEMP)].The patients were divided into normal inner ear group and abnormal inner ear group according to 3D-FLAIR results.The abnormal inner ear group included abnormal inner ear group A(exudation of blood labyrinth barrier)and abnormal inner ear group B(destruction of blood labyrinth barrier).The application value of 3D-FLAIR in the clinical diagnosis of SD was explored,and the hearing loss,vestibular function impairment and efficacy distribution of SD patients with different 3D-FLAIR examination results were analyzed.Results There was a significant difference in the positive rate of abnormal inner ear in SD patients among electrocochleogram,VEMP and 3D-FLAIR(P<0.05),and the positive rate of 3D-FLAIR was significantly higher than that of electrocochleogram and VEMP(P<0.05).Among the 84 SD patients,the degree of hearing loss was mainly severe hearing loss(44 cases,52.38%),and the type of hearing curve was mainly total hearing loss(43 cases,51.19%).There were 78 cases with abnormalities in 3D-FLAIR,including 12 cases in group A(abnormal inner ear group A)and 66 cases in group B(abnormal inner ear group B).There was no statistically significant difference in hearing loss degree distribution among the three groups(P>0.05),but there was a statistical difference in hearing curve type distribution among the three groups(P<0.05).Among the 84 SD patients,62 abnormal cases(73.81%)were shown by VEMP,29 abnormal cases(34.52%)by HIT,60 abnormal cases(71.43%)by VAT,and 54 cases abnormal(64.29%)by caloric test.There was a statistical significance in abnormal distribution of VEMP,VAT and caloric test among the three groups(P<0.05).Among the 84 SD patients,there were 12 cured cases(14.29%),19 markedly effective cases(22.62%),20 effective cases(23.81%)and 33 ineffective cases(39.28%).The distribution of efficacy revealed a statistical significance among the three groups(P<0.05).Conclusion 3D-FLAIR is helpful to understand the pathological status of inner ear in SD patients,and has a high detection rate of inner ear abnormality,and it can be used in the auxiliary diagnosis of SD to improve the effectiveness of treatment regimen.