發(fā)布時(shí)間：2018-01-15 09:06

  本文關(guān)鍵詞：正常聽(tīng)力兒童蝸神經(jīng)直徑及其與年齡相關(guān)性的MR研究　出處：《山東大學(xué)》2014年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 內(nèi)聽(tīng)道 蝸神經(jīng) 磁共振成像

【摘要】：目的： 測(cè)量不同年齡段正常聽(tīng)力兒童蝸神經(jīng)的直徑,同時(shí)探討其與年齡的相關(guān)性。 資料與方法： 搜集2011年11月至2014年3月因非聽(tīng)力原因于山東省醫(yī)學(xué)影像研究所行顱腦MR檢查的兒童156例,按年齡分為13組,即1個(gè)月-≤6個(gè)月、7個(gè)月-≤1歲以及2歲-12歲每間隔一歲為一組,每組隨機(jī)連續(xù)選取12例,其中男、女各6例。所有受試者均在常規(guī)顱腦MR檢查基礎(chǔ)上增加內(nèi)耳三維穩(wěn)態(tài)進(jìn)動(dòng)快速成像(the fast imaging employed steady-state acquisition, FIESTA)序列掃描。全部受試者家屬均簽署知情同意書(shū),并獲得本單位倫理委員會(huì)批準(zhǔn)。將聽(tīng)力篩查合格、顱腦及內(nèi)耳MRI顯示不存在內(nèi)耳或內(nèi)聽(tīng)道結(jié)構(gòu)異常及顱內(nèi)占位性病變、無(wú)神經(jīng)系統(tǒng)感染及耳毒性藥物應(yīng)用史、無(wú)個(gè)人或家族耳病史、身高、體重等發(fā)育正常者納入入組標(biāo)準(zhǔn),根據(jù)入組標(biāo)準(zhǔn)最終納入312只內(nèi)耳作為研究對(duì)象,男78例,女78例；左耳156只,右耳156只；年齡1個(gè)月-12歲,平均6.2±5.8歲。采用GE3.0T超導(dǎo)MR掃描儀(signa HDxt; GE medical systems,Milwaukee, Wis),8通道相控陣頭線(xiàn)圈為接收線(xiàn)圈,成像序列包括常規(guī)顱腦冠狀位T2WI FSE序列和內(nèi)耳3D-Fiesta序列掃描。在雙側(cè)蝸神經(jīng)入耳蝸處,選擇清晰顯示蝸神經(jīng)的橫斷面原始圖像放大5倍后分別測(cè)量其直徑；在斜矢狀位圖像上選取雙側(cè)內(nèi)聽(tīng)道中點(diǎn)、內(nèi)聽(tīng)道底,測(cè)量蝸神經(jīng)的上下徑及前后徑,計(jì)算上下徑及前后徑的平均值作為蝸神經(jīng)的直徑。采用雙盲法由兩位高年資MRI診斷醫(yī)師獨(dú)立進(jìn)行測(cè)量,取兩人的平均值作為最終測(cè)量結(jié)果。對(duì)兩名閱片者的測(cè)量結(jié)果行組內(nèi)相關(guān)系數(shù)(intraclass correlation coefficient,ICC)檢驗(yàn)；對(duì)不同性別、側(cè)別間蝸神經(jīng)直徑行t檢驗(yàn)；Pearson相關(guān)分析用于比較年齡和彼此參數(shù)間的相關(guān)性；單因素及多因素方差分析分別用于評(píng)價(jià)蝸神經(jīng)直徑在不同測(cè)量點(diǎn)、及其隨年齡增長(zhǎng)的變化,P0.05有統(tǒng)計(jì)學(xué)意義。 結(jié)果： 內(nèi)耳的3D-Fiesta橫軸位圖像上可以看到入耳蝸處的蝸神經(jīng),顯示為線(xiàn)狀低信號(hào)通入耳蝸；斜矢狀位圖像上面神經(jīng)、蝸神經(jīng)、前庭上神經(jīng)及前庭下神經(jīng)在圖像上能清晰顯示,顯示為類(lèi)圓形、橢圓形及逗號(hào)形低信號(hào)。2名閱片者對(duì)156例研究對(duì)象312耳的蝸神經(jīng)在不同測(cè)量點(diǎn)的測(cè)量結(jié)果和ICC值顯示,內(nèi)聽(tīng)道中點(diǎn)及內(nèi)聽(tīng)道底處的蝸神經(jīng)直徑比入耳蝸處蝸神經(jīng)的直徑明顯增大,正常值分別為1.12±0.08mm、1.05±0.06mm、0.87±0.14mm(P0.05)。從156名雙耳正常聽(tīng)力的研究對(duì)象中分析,各年齡組兒童蝸神經(jīng)在入耳蝸處、內(nèi)聽(tīng)道中點(diǎn)及內(nèi)聽(tīng)道底處的直徑在側(cè)別、性別間無(wú)明顯差異,P0.05。入耳蝸處、內(nèi)聽(tīng)道中點(diǎn)及內(nèi)聽(tīng)道底處的兒童蝸神經(jīng)直徑在年齡組間無(wú)明顯相關(guān)性,P0.05。 結(jié)論： 聽(tīng)力正常的兒童蝸神經(jīng)直徑在內(nèi)聽(tīng)道中點(diǎn)及內(nèi)聽(tīng)道底均大于入耳蝸處；且正常值不隨年齡的變化而改變。初步建立的兒童蝸神經(jīng)正常值范圍有助于先天性及獲得性感音性耳聾(Sensorineural Hearing Loss, SNHL)患者CI術(shù)前蝸神經(jīng)的評(píng)估。
[Abstract]:Objective:
The diameter of the cochlear nerve in children with normal hearing in different ages was measured, and the correlation with age was also discussed.
Information and methods:
From November 2011 to March 2014 in Shandong Province, the reason for non hearing Medical Imaging Research Institute for brain MR examination of 156 cases of children were divided into 13 groups, namely 1 months less than 6 months, 7 months and less than 1 years and 2 years old -12 years old every year as a group, each group were continuously select 12 cases, male, female 6 cases. All of the subjects were increasing fast imaging based on conventional 3D Fiesta inner ear craniacerebral MR (the fast imaging employed on steady-state acquisition, FIESTA) sequences. All of the subjects families signed informed consent, and approved the ethics committee. Hearing screening qualified, brain and inner ear MRI shows that there is no inner or internal auditory canal structural abnormalities and intracranial lesions, no nervous system infection and ototoxic medication history, no personal or family history of the disease, height, weight and other normal development into the group The standard, according to the inclusion criteria into the final 312 only the inner ear as the object of study, male 78 cases, female 78 cases; 156 left ear, right ear 156; aged 1 months -12 years old, average 6.2 + 5.8 years. Using the GE3.0T scanner (signa HDxt; GE superconducting MR medical systems, Milwaukee, Wis, 8) channel phased array head coil for receiving coil, imaging sequences including conventional brain coronal T2WI FSE sequences and 3D-Fiesta sequences. In the inner ear of bilateral cochlear ear cochlear, clearly reveal the original cross-sectional images of the cochlear nerve magnified 5 times its diameter were measured at the midpoint of the internal auditory canal; select bilateral oblique sagittal images, in at the end of the hearing, measurement of cochlear nerve on diameter and anteroposterior diameter, diameter and the calculation of the average diameter as before and after cochlear diameter. By using double blind method by two senior MRI radiologists independently measured, two of the average as the final measurement The amount of results. Measurement results of two readers for the intraclass correlation coefficient (intraclass correlation, coefficient, ICC) for inspection; gender, side between the cochlear nerve diameter t test; Pearson correlation analysis was used to compare the correlation between age and other parameters; univariate and multivariate analysis of variance were used for evaluation. Nerve diameter at different measurement points, and changes with age, P0.05 was statistically significant.
Result錛，

本文編號(hào)：1427668