弱听患儿内耳及头部核磁共振成像表现特征及价值分析
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摘要
目的:探究弱听患儿内耳及头部核磁共振成像(MRI)表现特征及临床诊断价值。方法:选取在医院确诊并进行治疗的50例弱听患儿纳入弱听组,另选取同期进行健康体检的50名儿童纳入正常对照组。对两组均进行内耳及头部常规MRI检查,对扫描所得原始图像进行最大密度投影(MIP)三维重建,并对图像进行多个角度的旋转和分析,结合原始图像对两组内耳结构的重要径线进行观察及测量。结果:弱听组患儿内耳结构主要径线前半规管高度、后半规管高度及外半规管高度测量均值均低于正常对照组儿童,其差异均有统计学意义(t=3.73,t=4.44,t=2.65;P<0.05);两组前半规管管径、后半规管管径及外半规管管径测量均值进行对比,弱听组患儿前半规管管径、后半规管管径及外半规管管径测量均值均低于正常对照组儿童,差异均具有统计学意义(t=2.38,t=3.92,t=4.79;P<0.05);两组耳蜗高度及耳蜗底周直径及耳蜗底周管径测量均值无统计学差异。结论:弱听患儿与健康儿童内耳及头部MRI图像存在明显差异,MRI检查对弱听患儿的临床诊断具有一定帮助。
Objective: To explore the performance characteristics and clinical diagnostic value of magnetic resonance imaging(MRI) for inner ear and head of children with amblyacousia. Methods: 50 children with amblyacousia who were diagnosed and treated in our hospital were selected as amblyacousia group in this study. At the same time, 50 children who received health physical examination in our hospital during the same period were selected as the normal group. Routine MRI examination were performed on the inner ear and head of the two groups, and 3 D reconstruction of maximal intensity projection(MIP) was performed on the original images obtained from the scanning. Besides, rotation and analysis with multiple angles were performed on the images. And combined with the original images, the important diameter lines of the inner ear structure of two groups were further observed and measured. Results: The mean values of the measured heights of the anterior, posterior and external semicircular canal of amblyacousia group were significantly lower than those of normal group(t=3.73, t=4.44, t=2.65, P<0.05). The mean values of the measured diameters of the anterior, posterior and external semicircular canal of the two groups were compared, and the mean values of the measured diameters of the anterior, posterior and external semicircular canal of amblyacousia group were significantly lower than those of normal group(t=2.38, t=3.92, t=4.79, P<0.05). The differences of mean values of cochlea height, the diameter of cochlea circumference and the canal diameter of cochlea circumference between two groups were not statistically significant. Conclusion: The MRI images of the inner ear and head of the children with amblyacousia are significantly different from those of healthy children, which is helpful to the clinical diagnosis for children with amblyacousia.
Objective: To explore the performance characteristics and clinical diagnostic value of magnetic resonance imaging(MRI) for inner ear and head of children with amblyacousia. Methods: 50 children with amblyacousia who were diagnosed and treated in our hospital were selected as amblyacousia group in this study. At the same time, 50 children who received health physical examination in our hospital during the same period were selected as the normal group. Routine MRI examination were performed on the inner ear and head of the two groups, and 3 D reconstruction of maximal intensity projection(MIP) was performed on the original images obtained from the scanning. Besides, rotation and analysis with multiple angles were performed on the images. And combined with the original images, the important diameter lines of the inner ear structure of two groups were further observed and measured. Results: The mean values of the measured heights of the anterior, posterior and external semicircular canal of amblyacousia group were significantly lower than those of normal group(t=3.73, t=4.44, t=2.65, P<0.05). The mean values of the measured diameters of the anterior, posterior and external semicircular canal of the two groups were compared, and the mean values of the measured diameters of the anterior, posterior and external semicircular canal of amblyacousia group were significantly lower than those of normal group(t=2.38, t=3.92, t=4.79, P<0.05). The differences of mean values of cochlea height, the diameter of cochlea circumference and the canal diameter of cochlea circumference between two groups were not statistically significant. Conclusion: The MRI images of the inner ear and head of the children with amblyacousia are significantly different from those of healthy children, which is helpful to the clinical diagnosis for children with amblyacousia.
引文
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[16]陈树斌,杨本涛,李永,等.颞骨扁平肥厚性脑膜瘤CT及MRI表现[J].中华耳科学杂志,2017,15(4):454-457.
[17]杨延,马辉,韩萍,等.迷路炎的CT、MRI表现及其图像融合的临床应用[J].临床放射学杂志,2017,36(3):430-433.
[18]张可,僧东杰,孙秉奎,等.先天性内耳畸形的CT、MRI表现[J].中国中西医结合影像学杂志,2017,15(6):731-733.
[19]方娴静,郑穗生,王龙胜,等.CT及MRI在感音神经性耳聋患者行人工耳蜗植入术前的应用价值[J].安徽医学,2017,38(12):1517-1519.
[20]赵俊锋,赵鑫,陆林,等.正常婴幼儿耳蜗导水管的HRCT表现及其径线与感音神经性耳聋患儿的差异[J].中国医学影像技术,2018,34(4):504-508.
[2]黄海峰.前列地尔治疗神经性耳聋的临床观察[J].中国保健营养,2017,27(31):125-126.
[3]Kuo CW,Wu HM.Fully endoscopic laser stapedotomy:is it comparable with microscopic surgery?[J].Acta Otolaryngol,2018,138(10):871-876.
[4]Lim HG,Kim JH,Shin DH,et al.Wireless charing pillow for a fully implantable hearing aid:Design of a circular array coil based on finite element analysis for reducing magnetic weak zones[J].Biomed Mater Eng,2015,26(Suppl1):S1741-1747.
[5]中华医学会放射学分会头颈学组.耳部CT和MRI检查及诊断专家共识[J].中华放射学杂志,2017,51(9):654-659.
[6]田卫卿.高压氧联合葛根素注射液治疗突发神经性耳聋62例疗效观察[J].中国实用神经疾病杂志,2017,20(10):56-58.
[7]解娟,郑体厚.耳聋左慈丸合复聪通脉开窍针刺法治疗神经性耳聋耳鸣疗效及对血清NO、Connexin 26的影响[J].现代中西医结合杂志,2017,26(33):3671-3673.
[8]姚志成.采用前列地尔治疗突发神经性耳聋的临床疗效[J].中国保健营养,2018,28(7):77.
[9]Timmer BH,Hickson L,Launer S.Adults with mild hearing impairment:Are we meeting the challenge?[J].Int J Audiol,2015,54(11):786-795.
[10]Horbach M,Verhey JL,Hots J.On the pitch strength of bandpass noise in normal-hearing and hearing-impaired listeners[J].Trends Hear,2018,22:2331216518787067.
[11]Dai L,Best V,Shinn-Cunningham BG.Sensorineural hearing loss degrades behavioral and physiological measures of human spatial selective auditory attention[J].Proc Natl Acad Sci USA,2018,115(14):E3286-E3295.
[12]梁思玉,李刚,郑芸,等.婴幼儿有意义听觉整合量表的应用现状与展望[J].中华耳科学杂志,2015,13(4):631-635.
[13]Asad AN,Purdy SC,Ballard E,et al.Phonological processes in the speech of school-age children with hearing loss:Comparisons with children with normal hearing[J].J Commun Disord,2018,74:10-22.
[14]Shekhawat GS,Searchfield GD,Stinear CM.The relationship between tinnitus pitch and hearing sensitivity[J].Eur Arch Otorhinolaryngol,2014,271(1):41-48.
[15]徐军,王波,吴晶涛,等.MSCT对正常内耳解剖结构的测量研究[J].实用放射学杂志,2015,31(1):31-34.
[16]陈树斌,杨本涛,李永,等.颞骨扁平肥厚性脑膜瘤CT及MRI表现[J].中华耳科学杂志,2017,15(4):454-457.
[17]杨延,马辉,韩萍,等.迷路炎的CT、MRI表现及其图像融合的临床应用[J].临床放射学杂志,2017,36(3):430-433.
[18]张可,僧东杰,孙秉奎,等.先天性内耳畸形的CT、MRI表现[J].中国中西医结合影像学杂志,2017,15(6):731-733.
[19]方娴静,郑穗生,王龙胜,等.CT及MRI在感音神经性耳聋患者行人工耳蜗植入术前的应用价值[J].安徽医学,2017,38(12):1517-1519.
[20]赵俊锋,赵鑫,陆林,等.正常婴幼儿耳蜗导水管的HRCT表现及其径线与感音神经性耳聋患儿的差异[J].中国医学影像技术,2018,34(4):504-508.