颅脑MRI对以突发性聋为首发症状的脑梗死患者的诊断意义

The Application of Brain MRI in the Diagnosis of Cerebral Infarction Patients with Sudden Deafness as the First Symptom

贾彦均;金永德;金玉莲;

1:延边大学附属医院(延边医院)耳鼻咽喉科头颈外科

摘要

目的探讨颅脑磁共振成像(MRI)对以突发性聋为首发症状的脑梗死患者的诊断价值。方法回顾性分析340例(352耳)突发性聋患者的临床资料,对其纯音测听和颅脑MRI检查结果进行分析。结果①340例突聋患者中,13例颅脑MRI的DWI像呈异常高信号,提示急性脑梗死,161例颅脑MRI提示腔隙性脑梗死,166例颅脑MRI未见异常。②13例急性脑梗死患者的梗死灶分布于脑干6例、小脑6例、脑桥臂2例、放射冠1例、右侧大脑半球1例、基底节1例、顶叶1例;纯音听阈显示8例(8耳)为全聋型,4例(4耳)为平坦下降型,1例(1耳)为低频下降型。③161例腔隙性脑梗死患者梗死灶分布于放射冠117例,半卵圆中心69例,基底节67例,额叶32例,丘脑21例,脑干16例,顶叶16例,侧脑室11例,胼胝体5例,枕叶3例,小脑1例,脑干合并小脑1例,大脑皮层1例;其中,18例(19耳)脑干、小脑腔隙性脑梗死患者的纯音听阈显示8例(9耳)为平坦下降型,7例(7耳)为全聋型,2例(2耳)为高频下降型,1例(1耳)为低频下降型。结论中重度聋或全聋的突聋患者合并高龄、高血压、眩晕等病史时,可能存在脑血管意外,尤其是脑干或小脑梗死,应尽快完善颅脑MRI检查,从而避免漏诊误诊。

关键词

突发性聋;磁共振成像;脑梗死

基金项目(Foundation):

国家自然科学基金项目(81860189)

作者

贾彦均;金永德;金玉莲;

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贾彦均金永德金玉莲