突聋患者内耳MRI钆造影与cVEMP的相关性研究

发布时间：2018-03-18 06:16

本文选题：突发性耳聋　切入点：内耳钆造影磁共振　出处：《中华耳科学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的通过对单侧突发性耳聋患者进行纯音测听、内耳钆造影MRI检查、cVEMP检查以探讨突聋患者的可能发病机制及在突聋患者中膜迷路积水与cVEMP异常的相关性。方法根据纯音测听结果对65例单侧突发性耳聋患者分为低频组、高频组、平坦组、全聋组,进行内耳钆造影MRI及cVEMP检查,比较各个组间钆造影阳性率和cVEMP阳性率;按照钆造影结果分组,分别计算钆造影阳性组、阴性组的cVEMP阳性率。结果 65例患者中,低频组14人,钆造影阳性率35.7%(5/14),cVEMP阳性率50%(7/14);高频组11人,钆造影阳性率0(0/11),cVEMP阳性率9.1%(1/11);平坦组17人,钆造影阳性率17.6%(3/17),cVEMP阳性率35.3%(6/17);全聋组23人,钆造影阳性率13.0%(3/23),cVEMP阳性率43.5%(10/23);低频组、平坦组、全聋组两两之间的钆造影阳性率无明显差异性;各个频率两两之间cVEMP阳性率未存在完全性明显差异;钆造影阳性共11例,cVEMP阳性共24例。其中钆造影阳性组中cVEMP阳性率63.64%(7/11),钆造影阴性组中cVEMP阳性率31.48%(17/54),二者差值具有统计学意义(P 0.05)。结论内耳钆造影MRI提示突发性耳聋目前仍是病因不明的疾病,膜迷路积水是低频型突发性聋的一种可能发病机制,而平坦型、全聋型突聋的膜迷路积水可能为内耳损伤后出现的一种病理结果;cVEMP可能在不同频率的突聋类型检出率无明显独特性,在一定程度上可能可以提示突发性聋患者存在膜迷路积水情况。
[Abstract]:Objective to conduct pure tone audiometry in patients with unilateral sudden deafness. In order to explore the possible pathogenesis of sudden deafness and the correlation between hydrolabyrinth and abnormal cVEMP in patients with sudden deafness, 65 patients with unilateral sudden deafness were divided into low frequency group according to the results of pure tone audiometry. High frequency group, flat group and total deafness group were examined with MRI and cVEMP. The positive rate of gadolinium angiography and positive rate of cVEMP were compared among each group, according to the results of gadolinium angiography, the positive rate of gadolinium angiography was calculated. Results the positive rate of gadoliniography in low frequency group (14 cases) was 35.7%, and the positive rate of gadoliniography was 50 / 7 / 14%. In high frequency group (11 cases), the positive rate of gadoliniography was 0.1% / 11%. The positive rate of gadolinium angiography was 17 cases in flat group (17 cases). The positive rate of gadolinium angiography was 17.617%. The positive rate of gadolinium examination was 35.31717%; and the positive rate of gadoliniography was 35.31717% in total deafness group (23 cases), and the positive rate of gadoliniography was 0.1% / 11% (n = 11), 17 cases in flat group (n = 17). The positive rate of gadolinium angiography was 13.0% and the positive rate of cVEMP was 43.5%. There was no significant difference between low frequency group, flat group and total deafness group, and there was no significant difference in positive rate of cVEMP between two groups. The positive rate of cVEMP in gadolinium-positive group was 63.64 / 11, and the positive rate of cVEMP in gadolinium-negative group was 31.48 / 54.The difference was statistically significant (P < 0.05). Conclusion Gadoliniography MRI indicates sudden deafness. Is still a disease of unknown etiology, Membranous hydrolabyrinth is a possible pathogenesis of low-frequency sudden deafness. The hydrops of membranous labyrinth in all deafness may be a pathological result after inner ear injury. The detection rate of camp may not be distinct in different frequency of sudden deafness. To some extent, it may indicate the presence of membranous labyrinth hydrops in patients with sudden deafness.
【作者单位】：福建医科大学附属第一医院耳鼻咽喉科;福建医科大学附属第一医院耳鼻咽喉科研究所;
【基金】：福建省医学创新课题(2014-CX-24)资助~~
【分类号】：R764.437

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