摘要
目的探讨采用内耳三维快速液体衰减反转恢复核磁共振(3D-FLAIRMRI)扫描技术用于发作性前庭综合征疑似疾病中的诊断价值。方法回顾性分析2018年7月至2019年12月于厦门大学附属第一医院眩晕门诊诊治的发作性前庭综合征疑似患者72例的临床资料,所有病例合并听力下降、耳鸣及反复眩晕发作病史,将其分为两组,疑似梅尼埃病患者37例,或疑似前庭性偏头痛患者35例,经静脉注射钆喷酸葡胺稀释液4 h后行内耳3D-FLAIRMRI。随访患者的阶梯治疗后确诊结果并分析其与钆造影提示结果的一致性。数据应用SPSS 19.0统计软件进行分析。结果37例疑似梅尼埃病患者中,有21例显示膜迷路积水征象而诊断为梅尼埃病;35例疑似前庭性偏头痛患者中,有4例显示膜迷路积水征象,诊断为梅尼埃病;随访并以阶梯治疗证实:膜迷路积水征象阳性25例中,有23例最终确诊为梅尼埃病,而47例膜迷路积水征象阴性者2例为梅尼埃病(以膜迷路积水征象诊断梅尼埃病的敏感度、特异度以及准确度分别为92.0%、95.9%和94.6%)。25例膜迷路积水征象阳性中合并前庭性偏头痛为3例,47例膜迷路积水征象阴性中最终确诊为前庭性偏头痛为29例(以膜迷路积水征象作为诊断前庭性偏头痛的敏感度、特异度以及准确度分别为90.6%、52.4%和68.9%)。结论采用经静脉注射钆喷酸葡胺稀释液造影后行内耳3D-FLAIRMRI技术,对发作性前庭综合征疑似疾病有重要的鉴别作用,有利于提高前庭疾病的诊断水平。
Objective To investigate the clinical value of 3D-FLAIR MRI in the diagnosis of paroxysmal vestibular syndrome.Methods The clinical data of 72 patients with suspected disease of paroxysmal vestibular syndrome diagnosed and treated in vertigo clinic of our hospital from July 2018 to December 2019 were analyzed retrospectively.All patients had a history of hearing loss,tinnitus and recurrent vertigo.They were divided into two groups:37 patients suspected of Meniere and 35 patients suspected of vestibular migraine.3D-FLAIR MRI of inner ear was performed after 4 hours of intravenous injection of GD DTPA diluent.The results of diagnosis were compared with those of gadolinium radiography.The data were analyzed by SPSS 19.0.Results Twenty-one patients with suspected Meniere's disease showed signs of water accumulation in the membranous labyrinth,4 patients with suspected vestibular migraine showed signs of water accumulation in the membranous labyrinth(P<0.01).Twenty-three patients with positive signs of water accumulation in the membranous labyrinth were finally diagnosed as Meniere's disease,while Meniere's disease was found in 2 cases of 47 patients with negative signs of membranous labyrinthine hydrops(the sensitivity,specificity and accuracy of the diagnosis of Meniere's disease were 92.0%,95.9%and 94.6%,respectively).Three cases were complicated with vestibular migraine in the 25 cases with positive signs of membranous labyrinthine hydrops,and 29 cases were finally diagnosed as vestibular migraine in 47 cases with negative signs of membranous labyrinthine hydrocephalus(the sensitivity,specificity and accuracy of diagnosing vestibular migraine with signs of membranous labyrinthine hydrops were 90.6%,52.4%and 68.9%,respectively).Conclusion The 3D-FLAIR MRI technique of inner ear after gadolinium radiography has an important role in distinguishing the suspected diseases of paroxysmal vestibular syndrome,and is helpful to improve the diagnosis level of vestibular diseases.
作者
上官翰京
何静
韩海伟
Shangguan Hanjing;He Jing;Han Haiwei(Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xiamen University,Xiamen Key Laboratory of Otolaryngology Head and Neck Surgery,Xiamen,Fujian 361003,China;Department of Radiology and Imaging,the First Affiliated Hospital of Xiamen University,Xiamen,Fujian 361003,China)
出处
《中国基层医药》
CAS
2020年第16期1961-1964,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
耳蜗前庭综合征
磁共振成像
梅尼埃病
偏头痛
迷路积水
Cogan syndrome
Magnetic resonance imaging
Meniere’s disease
Migraine disorders
Labyrinth diseases
