单侧突发性聋患者脑磁共振扩散峰度成像研究

目的探讨单侧突发性聋患者脑部磁共振弥散峰度成像(diffasion kurtosis imaging,DKI)检查对突聋预后的评估作用。方法收集右侧突发性聋患者32例(突聋组),(病程≤3周,男16例,女16例,年龄39~73岁,平均52.31±8.59岁),正常对照组23例(男11例,女12例,年龄41~68岁,平均56.36±6.82岁),对照组和突聋组治疗前行常规磁共振检查及全脑DKI成像扫描;基于统计软件比较突聋组与正常对照组全脑DKI各参数图差异脑区;并根据治疗结果,将突聋组患者分为显效组(20例)和无效组(12例),再分别与正常对照组比较。结果双样本t检验结果显示,与正常对照组比较,突聋组左侧的颞上回、颞中回及颞下回、左侧的顶叶及枕叶等脑区的白质有不同程度的各向异性分数(FA)值减小,突聋组双侧额叶均有平均扩散峰度(MK)值及径向峰度(RK)值增加。突聋组的显效组20例和无效组12例分别与正常对照组比较,可见突聋组的轴向分度(AD)在右侧额上回、右侧额中回、左侧额中回减小,右侧中央后回减小,径向分度(RD)在左侧扣带回、左侧颞上回减小,扩散峰度各向异性(KFA)在左侧枕上回、左侧角回、左侧扣带回增加,平均弥散率(MD)在右侧额叶直回增加,MK在左侧边缘叶、右侧额中回、右侧缘上回增大,这些区域的改变提示预后较好;AD、RD、KFA、MD、MK在颞上、中、下回减小,而枕叶、额叶无改变,则提示预后较差。结论DKI检查对突发性聋的预后评估有一定的指导作用,颞叶、额叶、枕叶均发生参数改变的患者预后较佳,参数改变发生在颞叶的患者,则其预后较差。

Diffusion Kurtosis Imaging Study in Patients with Unilateral Sudden Sensorineural Hearing Loss

Objective To investigate the significance of magnetic resonance diffusion kurtography(DKI)in patients with unilateral sudden deafness.Methods A total of 32 patients with right sudden deafness(course of disease≤3 weeks)were collected,including 16 males and 16 females,with an age range of 39<73 years,with an average age of 52.31±8.59 years.There were 23 people with coroul hearing in the normal control group,11 males and 12 females,with an age range of 41<68 years and an average age of 56.36±6.82 years.The conventional magnetic resonance imaging(MRI)and whole brain DKI imaging before treatment were performed.According to the prognosis of the treatment results,the patients were divided into improvement group and ineffective group,and then compared with the normal control group.Results In the right sudden deafness patients,the left superior temporal gyrus,middle temporal gyrus and infra temporal gyrus,the white matter of the parietal lobe and occipital lobe on the left side of the white matter decreased in FA parameters.In the sudden deafness group,the MK and RK increased in the bilateral frontal lobe.According to the prognosis of the treatment results,the patients were divided into improvement group(n=20)and ineffective group(n=12),which were compared with the normal control group.The AD parameters were in the right superior frontal gyrus,the right middle frontal gyrus and the right posterior central gyrus,the RD parameters were in the left cingulate gyrus,the KFA parameters were in the left superior occipital gyrus,the left angular gyrus and the left cingulate gyrus,the MD parameters were in the right gyrus rectus and the left middle frontal gyrus,and the MK parameters changed in the left marginal lobe,the right middle frontal gyrus and the right superior marginal gyrus.In the invalid group,the parameters of AD,RD,KFA,MD and MK occurred in the superior,middle and inferior temporal gyrus,but there was no change in the occipital lobe and forehead lobe.Conclusion DKI may medict the prognosis of patients with sudden hearing loss.Patients with parameter changes in temporal lobeming,frontal lobe and occipital lobe have better prognosis.In patients with only temporal lobe lesions,other brain regions were not reshaped and failed to re-establish or perform compensated hyperplasia,so the prognosis was poor.