感觉神经性耳聋的MRI研究

目的评价ＭＲＩ检查方法对探讨感觉神经性耳聋（ＳＮＨＬ）各种病因的价值。方法用ＳＥ和快速自旋回波（ＦＳＥ）序列对４９５例临床诊断为ＳＮＨＬ的患者进行磁共振检查。结果ＭＲＩ发现颅内病变２１１例（４２．６％），其中９５例（１９．２％）的ＳＮＨＬ病因为听觉传导通路上的病变。１１例内耳区病变为感觉性耳聋，另外８４例听神经或脑内听觉传导纤维受损为神经性耳聋。８４例中６２例病变位于内听道和桥小脑角区，脑内病变为２２例。结论ＳＮＨＬ病人ＭＲＩ检查应包括从耳蜗到颞横回的全部听觉传导通路。肿瘤、梗死软化、多发硬化、炎症、纡曲血管和囊肿都可引起ＳＮＨＬ。

MRI investigation of sensorineural hearing loss

Purpose To investigate the causes of sensorineural hearing loss(SNHL) and method of MR imaging. Methods 495 consecutive patients with SNHL examined with MRI were analyzed. Results An intracranial abnormality was found in 211(42.6%) of the patients with 95 (19.2%) along the acoustic pathway. Eleven of the 95 patients had sensory hearing loss while 84 had neural hearing loss with lesions affecting the retrocochlear auditory pathway. In 62 of the 84 patients, the internal acoustic canal and cerebellopontine angle were involved. Twenty-two patients had intra-axial lesions. Conclusion MR imaging in a patient with SNHL must cover the entire acoustic pathway from the cochlea to the temporal gyrus. Tumors, infarction, traumatic necrosis, multiple sclerosis, cyst, inflammation and ectopic vessel are responsible for SNHL.