语言前耳聋患者听皮质及相关解剖结构的MR扩散加权成像及波谱研究

目的 观察不同年龄段语言前感音神经性耳聋患者不同持续时间听皮质灰白质的变化及其机制.方法 9～12岁年龄组、19～22岁年龄组耳聋患者以及相应年龄组正常听力者各20名(对照组),分别行MR扩散加权成像以及MR波谱成像.测量听皮质的表观扩散系数(ADC)值以及N-乙酰天冬氨酸(NAA)/肌酸(Cr)、胆碱(Cho)/Cr的变化.3组间各数值的比较采用单因素方差分析.结果 对照组、9～12岁及19～22岁年龄组语言前耳聋患者左侧颞上回区域NAA/Cr值分别为2.46±0.51、2.49±0.52、2.26±0.33;右侧分别为2.26±0.46、2.44±0.45、2.27±0.46;左侧颞上回区域Cho/Cr值分别为0.88±0.21、0.92±0.18、0.87±0.13;右侧分别为0.88±0.18、0.87±0.22、0.81±0.16.3组间差异均无统计学意义(F值分别为1.17、0.14、0.62、1.15,P值均>0.05).对照组、9～12岁及19～22岁年龄组语言前耳聋患者左侧Heschl回的平均ADC值分别为(860±103)、(885±48)、(905±77)mm2/s,右侧为(848±73)、(880±61)、(902±52)mm2/s,3组间差异有统计学意义(F值分别为4.42、11.37,P值均<0.05).19～22岁年龄组双侧Heschl回的ADC值高于对照组(q值分别为-44.89、-54.28,P值均<0.05),9～12岁年龄组右侧Heschl回的ADC值高于对照组(q=-31.54,P<0.05).结论 语言前感音神经性耳聋后持续20年较对照组Heschl回ADC值增高,而颞上回的MR波谱代谢物则无变化.

The study of diffusion weighted imaging and MR spectroscopy in auditory cortex and related area of prelingual hearing-loss patients

Objective To study the time-dependent changes and mechanisms of auditory cortex in prelingual sensorineural hearing loss. Methods Two groups (9-12, 19-22-year-old) of hearing-loss patients and matched normal hearing subjects received MR diffusion and MRS examination. The ROI for ADC measurement were placed on the Heschl gyrus (HG), and for NAA/Cr, Cho/Cr on the superior temporal gyrus(STG). Results There was no statistical difference among groups both in the NAA/Cr and Cho/Cr (P>0.05), Left side NAA/Cr 2.46±0.51, 2.49±0.52, 2.26±0.33;Right side NAA/Cr 2.26±0. 46, 2. 44±0. 45, 2. 27±0. 46. Left side Cho/Cr 0. 88±0. 21,0. 92±0. 18, 0. 87±0. 13 ; Right side Cho/Cr 0. 88 ± 0. 18, 0. 87 ± 0. 22, 0. 81 ± 0. 16. There was statistical difference of ADC value among normal hearing subjects and 9-12, 19-22-year-old hearing-loss patients(F = 4. 42, P < 0. 05, F = 11.37,P<0. 05). There was significant difference of ADC value between normal hearing and 19-22 year-oldhearing-loss (q = - 44. 89, P = 0. 008, q = - 54. 28, P = 0. 027) on both left and right HG, and there wassignificant difference between normal hearing and 9-12 year-old hearing-loss only on right HG (q =- 32. 54, P = 0. 000), Left side (860 ± 103), (885 ± 48), (905±77) mm<'2>/s, Right side (848 ± 73),(880 ± 61), (902 ± 52) mm2/s. Conclusion Compared with the normal hearing, the ADC value increased in 20-year-length of deafness. The NAA/Cr and Cho/Cr of STG showed no changes among the three groups.