突发性聋磁共振检查的现状与进展

doi:10.6040/j.issn.1673-3770.0.2023.301

摘要/Abstract

摘要： 突发性聋是耳科学常见的疾病。近年来,其发病率逐年上升,并且发病年龄趋于年轻化。如何尽快判断突发性聋的原因并及时给出合理有效的治疗,成为目前关注和研究的热点和难点。随着影像学技术的不断发展和进步,学者们通过对突发性聋的患者进行内听道MRI检查,使突发性聋病因的检出率及预后判断的准确率逐渐提高。内听道MRI检查中的T₁WI、T₂WI、3D-T2Flair、DTI、DSI等序列,在显示和帮助医生发现内听道肿瘤、后颅窝梗死、内耳出血、迷路炎、神经纤维完整性及小脑前下动脉血管走行等突发性聋的病因方面,起到十分关键的作用。本文将分别从上述几个方面综述目前通过MRI检查判断突发性聋的病因及预后的现状及最新进展,并为及时选择最佳的治疗方案提供思路和见解。

关键词: 突发性聋, 核磁共振, 蜗后病变, 内耳出血, 迷路炎, 小脑前下动脉

Abstract: Idiopathic sudden sensorineural hearing loss is a common disease in Otology. Recently, its incidence rate has been increasing, and the age of onset appears to have become younger. The quick determination of the cause of idiopathic sudden sensorineural hearing loss, and the provision of reasonable and effective treatment in a timely manner has, accordingly, become a matter of focus. With the continuous development and progress of imaging technology, scholars have gradually improved the detection rate of the cause of sudden deafness and the accuracy of prognosis by conducting internal auditory canal magnetic resonance imaging(MRI)examinations. The T₁WI, T₂WI, 3D-T2Fair, DTI, DSI and other sequences in the MRI examination of the internal auditory canal play a crucial role in assisting clinicians in diagnosing the causes of sudden deafness. These may include internal auditory canal tumors, posterior cranial fossa infarctions, internal ear bleeds, labyrinthitis, loss of nerve fiber integrity, and the course of the anterior inferior cerebellar artery blood vessels. This article provides a comprehensive review of the current status and recent advancements in determining the etiology and prognosis of sudden deafness through MRI examinations of the above aspects,. Thus, this review provide valuable insights for the timely selection of optimal treatment plan.

Key words: Idiopathic sudden sensorineural hearing loss, Magnetic resonance imaging, Posterior cochlear lesions, Internal ear hemorrhage, Labyrinthitis, Anterior inferior cerebellar artery

中图分类号:

R764.43+7

郭翔,马永强,伊海金. 突发性聋磁共振检查的现状与进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 140-144.

GUO Xiang, MA Yongqiang, YI Haijin. Current status and advances in magnetic resonance imaging in sudden deafness[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 140-144.

参考文献

[1] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 突发性聋诊断和治疗指南(2015)[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(6): 443-447. doi:10.3760/cma.j.issn.1673-0860.2015.06.002
[2] Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical practice guideline: sudden hearing loss(update)[J]. Otolaryngol Head Neck Surg, 2019, 161(1_suppl): S1-S45. doi:10.1177/0194599819859885
[3] Ceylan A, Celenk F, Kemalo glu YK, et al. Impact of prognostic factors on recovery from sudden hearing loss[J]. J Laryngol Otol, 2007, 121(11): 1035-1040. doi:10.1017/S0022215107005683
[4] Moon IS, Kim J, Lee SY, et al. How long should the sudden hearing loss patients be followed after early steroid combination therapy?[J]. Eur Arch Otorhinolaryngol, 2009, 266(9): 1391-1395. doi:10.1007/s00405-009-0932-9
[5] Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical practice guideline: sudden hearing loss(update)executive summary[J]. Otolaryngol Head Neck Surg, 2019, 161(2): 195-210. doi:10.1177/0194599819859883
[6] Aarnisalo AA, Suoranta H, Ylikoski J. Magnetic resonance imaging findings in the auditory pathway of patients with sudden deafness[J]. Otol Neurotol, 2004, 25(3): 245-249. doi:10.1097/00129492-200405000-00008
[7] Nosrati-Zarenoe R, Hansson M, Hultcrantz E. Assessment of diagnostic approaches to idiopathic sudden sensorineural hearing loss and their influence on treatment and outcome[J]. Acta Otolaryngol, 2010, 130(3): 384-391. doi:10.1080/00016480903161541
[8] Fitzgerald DC, Mark AS. Sudden hearing loss: frequency of abnormal findings on contrast-enhanced MR studies[J]. AJNR Am J Neuroradiol, 1998, 19(8): 1433-1436.
[9] Schick B, Brors D, Koch O, et al. Magnetic resonance imaging in patients with sudden hearing loss, tinnitus and vertigo[J]. Otol Neurotol, 2001, 22(6): 808-812. doi:10.1097/00129492-200111000-00016
[10] Cadoni G, Cianfoni A, Agostino S, et al. Magnetic resonance imaging findings in sudden sensorineural hearing loss[J]. J Otolaryngol, 2006, 35(5): 310-316. doi:10.2310/7070.2006.0066
[11] Wood JW, Shaffer AD, Kitsko D, et al. Sudden sensorineural hearing loss in children-management and outcomes: a meta-analysis[J]. Laryngoscope, 2021, 131(2): 425-434. doi:10.1002/lary.28829
[12] 王紫仪, 林毅, 杨本涛. 迷路炎致单侧突发性聋患者MRI多序列分析[J]. 临床放射学杂志, 2022, 41(12): 2176-2179. doi:10.13437/j.cnki.jcr.2022.12.007 WANG Ziyi, LIN Yi, YANG Bentao. Multi-sequence analysis of MRI in patients with unilateral sudden deafness caused by labyrinthitis[J]. Journal of Clinical Radiology, 2022, 41(12): 2176-2179. doi:10.13437/j.cnki.jcr.2022.12.007
[13] Fujita T, Saito K, Kashiwagi N, et al. The prevalence of vestibular schwannoma among patients treated as sudden sensorineural hearing loss[J]. Auris Nasus Larynx, 2019, 46(1): 78-82. doi:10.1016/j.anl.2018.06.008
[14] 姜雨薇, 王宇辰, 王杰, 等. 多参数磁共振显示听神经瘤患者迷路信号改变的对比分析[J]. 中国耳鼻咽喉头颈外科, 2022, 29(11): 708-712. doi:10.16066/j.1672-7002.2022.11.007 JIANG Yuwei, WANG Yuchen, WANG Jie, et al. Comparative analysis of signal intensity changes of labyrinth in patients with acoustic neuroma by multiparameter magnetic resonance imaging[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2022, 29(11): 708-712. doi:10.16066/j.1672-7002.2022.11.007
[15] Lammers MJW, Young E, Fenton D, et al. The prognostic value and pathophysiologic significance of three-dimensional fluid-attenuated inversion recovery(3D-FLAIR)magnetic resonance imaging in idiopathic sudden sensorineural hearing loss: a systematic review and meta-analysis[J]. Clin Otolaryngol, 2019, 44(6): 1017-1025. doi:10.1111/coa.13432
[16] 饶良俊, 杨智云, 洪桂洵, 等. 特发性突发性耳聋内耳3D-FLAIR信号异常与临床[J]. 临床放射学杂志, 2014, 33(8): 1153-1156. doi:10.13437/j.cnki.jcr.2014.08.009 RAO Liangjun, YANG Zhiyun, HONG Guixun, et al. Idiopathic sudden deafness: abnormal inner ear high signal on 3D-FLAIR imaging and its clinical features[J]. Journal of Clinical Radiology, 2014, 33(8): 1153-1156. doi:10.13437/j.cnki.jcr.2014.08.009
[17] 陈怀军, 孙福忠, 陆海卫. 突发性耳聋几种治疗方法的疗效比较[J]. 社区医学杂志, 2005, 3(3): 8-9. doi:10.3969/j.issn.1672-4208.2005.03.006 CHEN Huaijun, SUN Fuzhong, LU Haiwei. Comparison of therapeutic effects of several treatment methods for sudden deafness[J]. Journal of Community Medicine, 2005, 3(3): 8-9. doi:10.3969/j.issn.1672-4208.2005.03.006
[18] Berrettini S, Seccia V, Fortunato S, et al. Analysis of the 3-dimensional fluid-attenuated inversion-recovery(3D-FLAIR)sequence in idiopathic sudden sensorineural hearing loss[J]. JAMA Otolaryngol Head Neck Surg, 2013, 139(5): 456-464. doi:10.1001/jamaoto.2013.2659
[19] Gao Z, Chi FL. The clinical value of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging in patients with idiopathic sudden sensorineural hearing loss: a meta-analysis[J]. Otol Neurotol, 2014, 35(10): 1730-1735. doi:10.1097/MAO.0000000000000611
[20] 毛椿平, 毛家骥, 张翔, 等. 磁共振弥散频谱成像机遇和挑战: 中国十年来发展成果及展望[J]. 磁共振成像, 2022, 13(10): 37-45. doi:10.12015/issn.1674-8034.2022.10.005 MAO Chunping, MAO Jiaji, ZHANG Xiang, et al. Opportunities and challenges of diffusion spectrum magnetic resonance imaging: achievements and prospects over the past decade in China[J]. Chinese Journal of Magnetic Resonance Imaging, 2022, 13(10): 37-45. doi:10.12015/issn.1674-8034.2022.10.005
[17] Prieto-Granada CN, Xu B, Alzumaili B, et al. Clinicopathologic features and outcome of head and neck mucosal spindle cell squamous cell carcinoma[J]. Virchows Arch, 2021, 479(4): 729-739. doi:10.1007/s00428-021-03117-2
[18] Feng L, Cai D, Muhetaer A, et al. Spindle cell carcinoma: the general demographics, basic clinico-pathologic characteristics, treatment, outcome and prognostic factors[J]. Oncotarget, 2017, 8(26): 43228-43236. doi:10.18632/oncotarget.18017
[19] Spector ME, Wilson KF, Light E, et al. Clinical and pathologic predictors of recurrence and survival in spindle cell squamous cell carcinoma[J]. Otolaryngol Head Neck Surg, 2011, 145(2): 242-247. doi:10.1177/0194599811402167
[20] Dubal PM, Marchiano E, Kam D, et al. Laryngeal spindle cell carcinoma: a population-based analysis of incidence and survival[J]. Laryngoscope, 2015, 125(12): 2709-2714. doi:10.1002/lary.25383

相关文章 15

[1]	王鑫,原晶晶,郝鹏鹏,闫占峰,刘建华,钟利群,刘思溟,吴薇,赵晓阳,张莹. 中药复方治疗突发性聋的疗效和可能机制:一项结合网络药理学研究的回顾性临床分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 6-17.
[2]	陈丹萍,何子键,虞幼军,周晓娓. 儿童突发性聋10年住院病例的疗效及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 16-22.
[3]	梁俊杰,张佳佳,张琳婧,孟言,李阳,白鹏. 中西医结合治疗突发性聋合并手足口病1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 91-95.
[4]	张佳佳,石安妮,邢御,洪玉颖,白鹏. 针刺联合西药治疗全聋型突发性聋1例与文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 88-92.
[5]	钟佳珂,王柏杨,伊海金. 以耳部症状首发、合并鼻咽占位的肉芽肿性多血管炎1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 6-14.
[6]	谭玉芳,易天华. 鼻咽癌放疗后突发性聋18例[J]. 山东大学耳鼻喉眼学报, 2021, 35(1): 35-39.
[7]	赵欢娣,成颖,杨军,张青. 3D-FLAIR MRI在内耳出血所致的SSNHL诊断中的作用[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 97-101.
[8]	魏馨雨,杨方园,杨军,张青. 耳源性细菌性迷路炎研究进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 102-107.
[9]	宗小芳,胡国华,钟时勋,雷艳,江黎珠,康厚墉. 影响低频下降型突发性聋不伴眩晕预后的相关因素分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 33-37.
[10]	叶毅良,卢标清. 704例突发性耳聋疗效分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 44-47.
[11]	钟晓声,杨海弟,郑亿庆. 突发性聋伴耳鸣的治疗与转归[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 43-46.
[12]	赵俊英,王建明. 单侧突发性聋与椎基底动脉影像学特征的相关性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 47-51.
[13]	张俊军,刘海莉,刘加福,秦小奉,杜洪明,王厚慧. 糖皮质激素不同给药方式治疗突发性聋的临床疗效及安全性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 52-55.
[14]	童巧珍,赵艳,程四华. 突发性聋患者负性情绪知信行模式构建及应用效果[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 162-164.
[15]	许明,罗兴谷,唐洪波,江青山. 儿童突发性聋的临床特征及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 41-44.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed