突发性聋患者内耳三维液体衰减反转恢复成像在预后评估中的价值

目的 探讨突发性聋患者内耳在三维液体衰减反转恢复(fluid attenuated inversion recovery,FLAIR)成像上的表现及其与疗效间关系.方法 23例突发性聋患者行三维FLAIR成像,观察内耳在FLAIR上的表现,并测定入院和治疗后的平均听阈,分析内耳信号与治疗结果之间关系.结果23例患者中8例患侧耳蜗在FLAIR上呈高信号,15例患侧及全部健侧耳蜗无信号.就诊时患侧耳蜗无信号组患者平均((x)±s,下同)听阈(听力级,下同)为(80±24) dB,耳蜗高信号组平均听阈为(92±18)dB,差异无统计学意义(t=1.245,P＞0.05);治疗后两组的平均听阈分别为(60±28)dB和(90±21)dB,有效率分别为60.0％和12.5％,差异均有统计学意义(P值均＜0.05).7例伴有眩晕患者中5例患侧半规管在FLAIR上呈高信号,此5例均治疗无效.结论三维FLAIR可显示突发性聋患者内耳淋巴液改变,呈高信号时疗效及预后差.

Three-dimensional fluid attenuated inversion recovery imaging at 3T MRI in sudden deafness: its findings and relationship with the prognosis

Objective To investigate inner ear of patients with sudden deafness with threedimensional fluid attenuated inversion recovery(3 D FLAIR) MRI,and the relationship between the results of 3D FLAIR and the prognosis.Methods Twenty-three patients with sudden deafness received 3D FLAIR at 3T MRI,and the signals of inner ear were recorded.Hearing levels were evaluated at initial visit and after treatment.The relationship between 3D FLAIR findings and hearing prognosis was evaluated.Results Eight patients with sudden deafness showed high signals in the affected cochlea on 3D FLAIR,the others of affected cochlea and all of contralateral cochlea showed no signal on 3D FLAIR.The age,sex,affected side,period to initial visit and initial audiogram had no difference between cochlea no signal group and high signal group.The average auditory threshold (~ ± s) in cochlea high signal group (90 ± 21 ) dB HL was significant higher than that in cochlea no signal group (60 ±28) dB HL,P ＜0.05 at patients' discharge.After treatment,in cochlea no signal group,two cases' hearing was complete recovered,remarkable improvement in five cases,slight improvement in two cases and no change in six cases.In cochlea high signal group,hearing was slight improvement in one case and no change in seven cases.The prognosis was significant difference between two groups.Five of seven patients with vertigo and sudden deafness showed high signal in affected side vestibule on 3D FLAIR,and the hearing of whom had no change after treatment.Conclusion 3D FLAIR can show high signal in affected inner ear in sudden deafness patients,and which is related to a poor hearing prognosis.