Ramsay Hunt综合征的MRI表现

目的　探讨RamsayHunt综合征的MRI表现及诊断价值。 方法　 5例临床确诊的单侧RamsayHunt综合征患者 ,男 3例 ,女 2例 ,年龄 2 9～ 5 4岁 ,行MR平扫及钆喷替酸葡甲胺 (Gd DTPA)增强检查 ,其中 3例增强前后对面神经颞骨内各节段分别测量信号强度。 5例均进行面神经各节段信号强度的双侧对比及增强前后对比。结果　 4例患侧面神经节段性异常强化 (双侧信号强度增强差值 >2 0或评分相差 1级或以上 ) ,1例双侧面神经强化无差别。膝状神经节 (4/ 4 )和迷路段(3/ 4 )的异常强化相对多见 ,内听道末段、鼓室段和乳突段各有 2例异常强化。结论　对于单侧患病者来说 ,只有患侧面神经节段性强化高于健侧相应节段才有诊断意义。RamsayHunt综合征较易累及迷路段和膝状神经节。Gd DTPA增强MRI能够客观地反映面神经的病变节段 ,有助于临床诊断及鉴别诊断 ,具有一定的临床实用价值。该项检查结果与临床表现的关系还需进一步研究。

MRI findings of Ramsay Hunt syndrome

Objective To investigate the MR findings and diagnostic value in Ramsay Hunt syndrome. Methods MRI plain and Gd-DTPA enhanced scans were performed in 5 unilateral Ramsay Hunt syndrome patients proved by clinical representation and examinations. The patients included 3 men and 2 women, and their age ranged from 29 to 54 years. The signal intensities of segments of facial nerves within temporal bone were measured pre- and post-gadolinium injections in 3 cases .Of all 5 cases, bilateral contrast of segments of facial nerves at both pre- and post-gadolinium injections was made. Results Segmental enhancement was found in 4 cases (the difference of bilateral enhancement signal intensities >20, or the grade of difference is 1 or above), while no difference of bilateral enhancement was found in 1 case. Abnormal enhancement of ganglion geniculi (4/4) and labyrinthine segment (3/4) was relatively frequent, abnormal enhancement of distal part of internal auditory segment, tympanic segment, and mastoid segment was seen in 2 cases, respectively.Conclusion MRI doesn't have diagnostic value unless the enhancement of segments of the affected facial nerve side is more evident than the unaffected side for unilateral cases. Labyrinthine segment and ganglion geniculi are more susceptible to Ramsay Hunt syndrome. Gd-DTPA enhanced MRI can demonstrate segmental lesions of facial nerves objectively, thus it can be helpful in the diagnosis and differential diagnosis of Ramsay Hunt syndrome. The relationship between MRI findings and clinical representation still needs further study.