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内耳显影对迟发性膜迷路积水诊断的意义

The Application of Endolymphatic Space Imaging in the Diagnosis of Delayed Endolymphatic Hydrops

吴倩如;张国明;赵梦龙;沙炎;戴春富;

1:复旦大学附属眼耳鼻咽喉科医院耳神经颅底外科

2:卫生部听觉医学重点实验室

3:浙江省绍兴市第五人民医院耳鼻咽喉科

4:复旦大学附属眼耳鼻咽喉科医院放射科

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摘要

目的明确鼓室内钆造影剂注射后内耳显影对迟发性膜迷路积水(delayed endolymphatic hydrops,DEH)诊断的临床价值,探讨迟发性膜迷路积水的病理机制。方法 10例DEH患者行双鼓室钆造影剂注射24小时后行三维快速液体衰减反转恢复(three dimensional fluid-attenuated inversion recovery,3D-FLAIR)序列和三维实时反转恢复(three dimensional real inversion recovery,3D-real IR)序列扫描成像,分析患者内淋巴积水的范围及严重程度。结果 10例DEH患者中9例为同侧型,1例为对侧型,均显示单侧或双侧内淋巴积水征象,其中9例同侧型DEH患者中仅1例(11.1%)患侧耳前庭内淋巴显示轻度积水,其余8例(88.9%)均显示患侧前庭内淋巴重度积水;8例(88.9%)同侧型DEH患者患侧耳蜗内淋巴积水,而1例(11.1%)同侧型DEH患者患侧耳蜗内淋巴无积水,9例同侧DEH患者对侧耳均未见前庭、耳蜗内淋巴积水。1例对侧型DEH患者的双侧前庭内淋巴重度积水,右侧耳蜗内淋巴轻度积水,而左侧耳蜗未见积水。结论内淋巴积水是DEH的主要病理因素,鼓室内钆注射后内耳显影能直观地反映出DEH患者内淋巴积水的范围及严重程度。

关键词

迟发性膜迷路积水;内耳显影;鼓室内注射

基金项目(Foundation):

国家自然科学基金(81070785;81170909);; 卫生公益行业专项基金(201202001)资助

作者

吴倩如;张国明;赵梦龙;沙炎;戴春富;

参考文献

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