突发性耳聋患者椎动脉超声多普勒的临床表现

突发性是耳聋是一种病因尚不明确的感觉神经性耳聋,多见于40岁以上的人群,具有发病急、病情进展迅速等特点,预后与患者就诊时间密切相关.有学者认为[1～4],血管因素引起的单耳突发性耳聋占所有患者的3/4左右,本文旨在探讨突发性耳聋患者行椎动脉超声多普勒的临床表现.     

高压氧综合治疗突发性耳聋疗效分析

突发性耳聋临床较多见，好发年龄多为20～40岁。由于此病病因不清，发病机理复杂，目前临床尚无特效的治疗方法。近几年国内外采用高压氧治疗突发性耳聋取得较好疗效，本院自1999年以来收治了90例突发性耳聋患者，其中经高压氧综合治疗48例取得了一定疗效，现报告如下。     

舒血宁治疗突发性耳聋的疗效观察

突发性耳聋是耳鼻咽喉科的常见急症之一，常有耳鸣，部分患者且有眩晕、恶心、呕吐及耳闷胀感。突发性耳聋的病因至今不明，发病机制不清。因此，临床治疗方法较多，但疗效不确定。从2003年8月-2004年8月，应用舒血宁治疗突发性耳聋患者40例(44耳)，取得了较好疗效。现报道如下。     

突发性耳聋的病因学及MR研究现状

突发性耳聋的发病率逐渐上升,但病因不清.随着影像学技术的发展,MR越来越多地用于对突发性耳聋的诊断,就突发性耳聋的病因学分类及MR研究现状予以综述.     

突发性耳聋的病因学及MR研究现状

突发性耳聋的发病率逐渐上升，但病因不清。随着影像学技术的发展，MR越来越多地用于对突发性耳聋的诊断，就突发性耳聋的病因学分类及MR研究现状予以综述。     

高压氧加丹参注射液联合治疗突发性耳聋的疗效观察

目的 探讨高压氧加复方丹参注射液联合治疗突发性耳聋的临床应用价值。方法 A组18例突发性耳聋患者行高压氧加复方丹参注射液联合治疗;B组21例突发性耳聋患者单纯使用复方丹参注射液治疗。结果 A组治愈率25％、显效率50％,总有效率85％均明显优于B组(P<0.05),尤其是显效率有非常显著差异(P<0.01)。结论 高压氧加复方丹参注射液联合治疗突发性耳聋可显著提高其疗效,且对伴有严重耳鸣的重度突聋患者亦有明显疗效。     

鼓膜鼓室内穿刺注射地塞米松治疗突发性耳聋

目的：对在鼓膜鼓室内注射地塞米松治疗突发性耳聋疗效的探讨研究。方法对收住院的50名突发性耳聋患者，随机分为观察组，对照组，观察组采取在鼓室内注射地塞米松治疗突发性耳聋，对照组采取常规静脉注射地塞米松治疗突发性耳聋，对观察组与对照组治疗效果给予对比研究。结果比较差异有统计学意义（P＜0．05）。结论在鼓室内注射地塞米松治疗突发性耳聋的效果明显优于常规静脉注射地塞米松治疗突发性耳聋，并且副作用少，临床值得推广。     

高压氧综合治疗突发性耳聋30例疗效分析

突发性耳聋是一种突然发生的感音神经性耳聋,患者听力通常在短时间内(一般在12 h左右)下降至最低点,耳聋程度常较严重,病因多而复杂[1].笔者比较了包括高压氧(hyperbaric oxygen,HBO)在内3种不同的治疗方法治疗突发性耳聋的临床疗效.现报告如下.     

正常人及突发性耳聋患者听觉功能性磁共振的初步研究

目的：用血氧水平依赖脑功能成像(blood-oxygen level dependent functional MRI，BOLD fMPI)对正常受试者及突发性耳聋患者听觉中枢进行定位并简单比较其异同。方法：健康志愿者10例，男6例，女4例，年龄24～51岁，平均36．4岁。以及突发性耳聋患者2例。所有正常志愿者刺激期，均接受单耳2000Hz纯音频刺激；基线期，无音频刺激。对于突发性耳聋患者，根据其电测听结果，给予相应听力下降频率的阈上及阈下刺激。实验数据均使用SPM99处理。结果：对于听力正常志愿者，fMRI结果显示双侧颞上回有较明显的激活，刺激对侧激活范围及强度均超过刺激同侧。对于突发性耳聋患者，给予阈下刺激时，脑内未发现明确的听觉激活区；给予阈上刺激时，可以发现双侧颞上回有较明显的激活，但双侧听觉中枢的激活程度及范围基本相近。结论：MRI可以显示正常人听觉中枢所在位置，因此当病变累及到听觉中枢时，可以用fMRI方法对突发性耳聋是中枢性的还是外周性的做出判断，若为中枢性的，则可显示听觉中枢的受累情况，对突发性耳聋的治疗给出指导性建议。     

钴宾酰胺治疗突发性耳聋21例疗效观察

目的：探讨钴宾酰胺治疗突发性耳聋的临床疗效。方法：将39例突发性耳聋患者随机分为2组,治疗组给予钴宾酰胺及舒血宁、前列地尔治疗,对照组仅给予舒血宁、前列地尔治疗,比较两组的总有效率。结果：治疗组与对照组总有效率分别为85.71%,66.67%,二者比较具有显著性差异（P〈0.05）。结论：钴宾酰胺是治疗突发性耳聋的有效药物。     

头颅CT血管成像对老年人突发性聋的诊断价值

目的 评价头颅CT血管成像(CT angiography,CTA)检查对老年人突发性聋病因诊断的价值.方法 分析38例突发性聋资料,按年龄分成2组:老年组(≥60岁)20例,中青年组(＜60岁)18例,对2组患者进行CTA检查,判断颅内血管狭窄情况.结果 16例老年患者及6例中青年组患者存在颅内动脉狭窄病变,患病率分别为80.0％和33.3％.2组患者颅内动脉狭窄患病率差异有统计学意义(P＜0.01).老年组56.1％的颅内动脉狭窄发生在后循环.结论 本组老年突发性聋患者后循环脑动脉狭窄发生率较高,提示该组患者突发性聋表现可能由内听动脉梗塞或缺血所致,老年人突发性聋患者可采用CTA检查判断颅内血管病变情况,为临床治疗提供依据.     

脑梗死患者的热成像研究

目的：评价热成像对颈内动脉脑梗死的辅助诊断价值。方法：利用ＢＰＭ－Ｉ型电调焦ＨＴＩ功能诊断仪对３６例颈内动脉脑梗死,３０例正常对照及１４例其他神经系统疾病患者进行检查,并做比较。结果：３２例（８８．９％）脑梗死患者的病变侧有冷区表现,而正常对照组中仅有４例出现冷区,两组经统计处理有显著性差异,Ｐ〈０．００１。结论：热成像对颈内动脉梗死有一定的辅助诊断价值。     

Prognostic value of 18F-fluoroethyl-L-tyrosine PET and MRI in small nonspecific incidental brain lesions.

Nonspecific incidental brain lesions (NILs) are being detected more frequently because of an increasing number of screening or research MRI scans of the brain, and their natural course is uncertain. METHODS: In a prospective cohort study starting in 1999, we determined the outcomes of patients with incidental, nonenhancing, supratentorial, lobar, and small-volume (<10 mL) lesions, depending on the findings of MRI and PET with the (18)F-labeled amino acid fluoroethyl-l-tyrosine ((18)F-FET). Patients with seizures, focal neurologic deficits, signs of local or systemic infection or inflammation, known brain disease, or any kind of previous cerebral treatment were excluded. Finally, 21 patients were eligible. MRI was performed in 19 of these patients because of nonspecific symptoms (such as headaches, dizziness, or sudden deafness), whereas 2 patients were healthy volunteers in MRI studies. Clinical follow-up and MRI scans were obtained at 4- to 6-mo intervals, and follow-up ranged from 3 to 8.5 y. Mean lesion-to-brain (L/B) ratios of >or=1.6 on (18)F-FET PET were rated as positive. RESULTS: Four different outcome groups were identified. In group A, 5 NILs regressed or vanished completely. All of these lesions were circumscribed on MRI, and (18)F-FET uptake was negative, with an L/B ratio of 1.2+/-0.2 (mean +/- SD). In group B, 10 NILs were stable, without growth. All of these lesions were circumscribed on MRI, and (18)F-FET uptake was negative (L/B ratio: 1.0+/-0.1). In group C, 2 NILs grew slowly over years, and an astrocytoma of World Health Organization (WHO) grade II was diagnosed after resection in each case. The lesions were circumscribed on MRI, and (18)F-FET uptake was negative (L/B ratios: 0.7 and 1.0). In group D, 4 NILs showed sudden and rapid growth, with clinical deterioration, and a high-grade glioma of WHO grade III or IV was diagnosed after resection in all cases. The lesions were diffuse on MRI, and (18)F-FET uptake was significantly increased (L/B ratio: 2.0+/-0.4) (P<0.01 for group D vs. group A or group B). CONCLUSION: For NILs, a circumscribed growth pattern on MRI and normal or low (18)F-FET uptake on PET are strong predictors for a benign course, with the eventual development of a low-grade glioma. In contrast, NILs with a diffuse growth pattern on MRI and increased (18)F-FET uptake indicate a high risk for the development of a high-grade glioma.     

高压氧治疗突发性耳聋的疗效及疗程选择

目的:探讨高压氧联合药物治疗对突发性耳聋的疗效判定及疗程的选择。方法:选取中国科学技术大学第一附属医院耳鼻咽喉科2017年1月至2018年12月收治的突发性耳聋患者95例。依据患者意愿分为对照组(单纯药物治疗,33例)、高压氧5次组(药物联合高压氧5次治疗,32例)和高压氧10次组(药物联合高压氧10次治疗,30例)。治疗前后比较纯音听力变化,观察3组患者不同治疗方案疗效的差异。结果:对照组总有效率54%,高压氧5次组总有效率56%,高压氧10次组总有效率83%。高压氧10次组疗效明显优于对照组和高压氧5次组,差异有统计学意义( P<0.05),对照组和高压氧5次组之间总有效率差异无统计学意义( P>0.05)。 结论:高压氧联合药物治疗有利于突聋患者听力恢复,但治疗疗程需满足1个疗程即10次治疗。     

MRI of Wolfram syndrome (DIDMOAD)

Wolfram syndrome (DIDMOAD) is a rare diffuse neurodegenerative disorder characterised by diabetes insipidus, diabetes mellitus, optic atrophy, deafness, and a wide variety of abnormalities of the central nervous system, urinary tract and endocrine glands. It may be familial or sporadic. Reported features on MRI of the brain are absence of the physiological high signal of the posterior lobe of the pituitary, shrinkage of optic nerves, chiasm and tracts, atrophy of the hypothalamic region, brain stem, cerebellum, and cerebral cortex. We report a 12-year-old girl with a 5-year history without brain stem, cerebellar or cerebral atrophy. MRI showed an unusual feature: a focus of high signal on PD- and T2-weighted images in the right substantia nigra. This is consistent with previously reported neuropathological post-mortem studies, but has never been reported in vivo. Received: 23 November 1998 Accepted: 23 March 1999     

甲钻胺对64例突发性耳聋患者耳鸣症状的疗效观察

目的观察甲钴胺对改善突发性耳聋患者耳鸣症状的疗效。方法运用前瞻分组对照研究的方法,取发病7d内就诊且伴有耳鸣的突发性耳聋患者64例,按就诊先后顺序分为治疗组及对照组,两组均应用东菱克栓酶（DF-521）、丹参、地塞米松、辅酶A等常规药物治疗,治疗组加用甲钴胺注射液500μg肌注1次／d;对照组加用生理盐水注射液10ml肌注1次／d。10d为1个疗程,治疗2个疗程。疗程结束1个月后观察患耳耳鸣恢复情况。结果治疗组耳呜恢复有效率为52．9％;对照组有效率为26．7％,差异有统计学意义（P＜0．05）。结论甲钴胺对改善突发性耳聋患者的耳鸣症状有明显效果。     

角膜炎·鱼鳞病·耳聋综合征的临床与MR诊断(附1例报告及文献分析)

目的:探讨先天性鱼鳞病、感音神经性耳聋、血管化角膜炎的临床、MR表现,深化对本病的认识。方法:报告国内首例经临床确诊的先天性鱼鳞病、感音神经性耳聋、血管化角膜炎的临床、MR表现,并复习文献。结果:本病有三大临床特征,即血管化角膜炎、鱼鳞病、先天性感音神经性耳聋,MR表现小脑发育不良,第四脑室囊状扩大,呈Dandy-Walker’s综合征改变。结论:MR表现Dandy-Walker’s综合征是本病诊断的有力证据。     

急性脑外伤CT与MRI的对比分析

目的比较急性脑外伤CT与MRI检查各自的优势,探讨弥散成像(DWI)对急性脑外伤的应用价值。方法对54例急性脑外伤患者,用自身对比的方法进行CT与MRI检查;分析两者的优缺点。结果54例中,对蛛网膜下腔出血、超急性期脑出血及骨折的显示,CT较MRI好,但CT漏诊脑挫裂伤5例、轴突剪切伤5例、急性脑白质水肿2例、硬膜下血肿1例。DWI对轴突剪切伤及急性脑白质水肿优于CT及常规MRI。结论对诊断急性外伤性脑出血及颅骨骨折CT优于MRI,其他方面MRI更优于CT。DWI应作为急性脑外伤的常规扫描方法。CT与MRI2种检查方法对诊断有互补作用。     

Voxel-based statistical analysis of cerebral glucose metabolism in the rat cortical deafness model by 3D reconstruction of brain from autoradiographic images

PURPOSE: Animal models of cortical deafness are essential for investigation of the cerebral glucose metabolism in congenital or prelingual deafness. Autoradiographic imaging is mainly used to assess the cerebral glucose metabolism in rodents. In this study, procedures for the 3D voxel-based statistical analysis of autoradiographic data were established to enable investigations of the within-modal and cross-modal plasticity through entire areas of the brain of sensory-deprived animals without lumping together heterogeneous subregions within each brain structure into a large region of interest. METHODS: Thirteen 2-[1-(14)C]-deoxy-D: -glucose autoradiographic images were acquired from six deaf and seven age-matched normal rats (age 6-10 weeks). The deafness was induced by surgical ablation. For the 3D voxel-based statistical analysis, brain slices were extracted semiautomatically from the autoradiographic images, which contained the coronal sections of the brain, and were stacked into 3D volume data. Using principal axes matching and mutual information maximization algorithms, the adjacent coronal sections were co-registered using a rigid body transformation, and all sections were realigned to the first section. A study-specific template was composed and the realigned images were spatially normalized onto the template. Following count normalization, voxel-wise t tests were performed to reveal the areas with significant differences in cerebral glucose metabolism between the deaf and the control rats. RESULTS: Continuous and clear edges were detected in each image after registration between the coronal sections, and the internal and external landmarks extracted from the spatially normalized images were well matched, demonstrating the reliability of the spatial processing procedures. Voxel-wise t tests showed that the glucose metabolism in the bilateral auditory cortices of the deaf rats was significantly (P<0.001) lower than that in the controls. There was no significantly reduced metabolism in any other area, and no area showed a significant increase in metabolism in the deaf rats with the same threshold, demonstrating the high localization accuracy and specificity of the method developed in this study. CONCLUSION: This study established new procedures for the 3D reconstruction and voxel-based analysis of autoradiographic data which will be useful for examining the cerebral glucose metabolism in a rat cortical deafness model.     

Disseminated tuberculomas in spinal cord and brain demonstrated by MRI with gadolinium-DTPA

Summary Intramedullary tuberculoma is rare, and there has been no report of concurrent intramedullary and intracerebral tuberculomas. We report a 30-year-old man with miliary tuberculosis of the lung. He suffered sudden paraplegia due to tuberculomas in the thoracic spinal cord and MRI showed more tuberculomas in the cervical spinal cord, brain stem, and cerebral and cerebellar hemispheres. The tuberculomas were isointense on the T1-weighted images, and hyperintense on the T2-weighted images; there was marked enhancement with intravenous gadolinium-DTPA. All the tuberculomas were very small 1 year after antituberculous chemotherapy.