本文選題：內(nèi)耳 + 磁共振水成像　； 參考：《新疆醫(yī)科大學》2011年碩士論文

【摘要】：目的：探討磁共振水成像技術(shù)(Magnetic resonance hydrography MRH)的三種后處理方法,即多平面重建(MPR)、最大密度投影(MIP)、容積再現(xiàn)(VR)對內(nèi)耳顯示分別有各自優(yōu)勢,為不同內(nèi)耳原因?qū)е碌母幸羯窠?jīng)性耳聾(SNHL)選擇簡單、合理、有效的掃描序列和最佳后處理方法,為臨床無創(chuàng)評估內(nèi)耳病變及診斷治療提供客觀有效的影像學依據(jù)。方法：對80例無聽力障礙的正常人及45例臨床確診為SNHL的患者行高分辨率三維快速自旋回波T2加權(quán)序列(3D TSE T2WI)行橫斷面掃描,然后行3D TSE T2WI雙側(cè)斜矢狀面掃描。對45例SNHL患者加掃T1WI,若該序列顯示有異常信號則行T1WI掃描。數(shù)據(jù)采集后傳至工作站利用ViewForum后處理軟件行MPR、MIP、VR重建。觀察正常內(nèi)耳及內(nèi)聽道解剖結(jié)構(gòu)的顯示情況,并進行測量。應用統(tǒng)計學方法對測量值及不同后處理技術(shù)對內(nèi)耳各解剖結(jié)構(gòu)評分,分別行組間及不同后處理方法間的差異性檢驗。結(jié)果：(1)正常志愿者組80例160耳均能清晰地顯示耳蝸前庭神經(jīng)、面神經(jīng)、蝸神經(jīng)及內(nèi)耳膜迷路的細微解剖結(jié)構(gòu)。(2)VR、MIP測量前、水平、后半規(guī)管最大徑及管徑,蝸管管徑及最大徑差異有統(tǒng)計學意義；VR、MIP圖像質(zhì)量的差異有統(tǒng)計學意義；VR、MIP、MPR顯示膜迷路諸結(jié)構(gòu)及神經(jīng)的能力的差異具有統(tǒng)計學意義；(3)45例病人中MRI內(nèi)耳發(fā)現(xiàn)有9例異常(陽性率20%),共7種病變,其中兒童(小于14歲)以先天性異常-前庭導水管擴大(3例)最常見。結(jié)論：(1)內(nèi)聽道及膜迷路的細微結(jié)構(gòu)可利用磁共振內(nèi)耳水成像技術(shù)得以立體而直觀的顯示,具有其他方法不可替代的作用；(2)MRH對SNHL病因的診斷有很好的指導作用,是有效的影像學檢查方法；(3)在多種內(nèi)耳水成像技術(shù)的后處理方法中,MPR在顯示神經(jīng)方面具有優(yōu)勢,VR在觀察膜迷路形態(tài)方面更具優(yōu)勢,其圖像更清晰,與周圍結(jié)構(gòu)的毗鄰關(guān)系顯示的更加確切,能對內(nèi)耳形態(tài)是否具有改變進行更有效地評估。
[Abstract]:Objective: to investigate the advantages of three post-processing methods in magnetic resonance hydrography MRH, I. e., multiplanar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR). For sensorineural hearing loss (SNHL) caused by different inner ear causes, simple, reasonable, effective scanning sequence and the best post-processing method were selected, which provided objective and effective imaging basis for clinical non-invasive evaluation and diagnosis and treatment of inner ear lesions. Methods: high resolution 3D fast spin echo T 2WI (3D TSE T 2WI) was performed on 80 normal subjects without hearing impairment and 45 patients with SNHL. Then the bilateral oblique sagittal scan was performed on 3D TSE T 2WI. T1WI was performed in 45 patients with SNHL. The data was collected and transferred to the workstation to reconstruct the data using the View Forum post-processing software line MPR-MIPPU VR. The anatomical structure of normal inner ear and internal auditory canal was observed and measured. The anatomic structures of the inner ear were scored by statistical method and different post-processing techniques were used to test the differences between groups and different post-processing methods. Results: (1) the fine anatomical structures of vestibular nerve, facial nerve, cochlear nerve and inner ear membrane labyrinth could be clearly displayed in 80 normal volunteers group (n = 80). (2) the maximum diameter and diameter of posterior semicircular canal before, at, and in posterior semicircular canal were measured by VRMIP. There were statistically significant differences in the diameter and maximum diameter of the cochlear canal. There were significant differences in the image quality of VRN MIP. The MPR showed the structures and nerves of the membranous labyrinth with statistical significance. (3) among the 45 cases, 9 cases (20%) were abnormal in the inner ear of MRI, there were 7 kinds of lesions, among them, congenital abnormality (< 14 years old) was the most common in children (3 cases) with congenital abnormal vestibular aqueduct enlargement (3 cases). Conclusion: (1) the fine structures of internal auditory canal and membranous labyrinth can be displayed stereoscopically and intuitively by magnetic resonance inner ear imaging, and MRH can not be replaced by other methods. (2) MRH has a good guiding role in the diagnosis of SNHL. (3) MPR has an advantage in displaying nerves and VR has more advantages in observing the shape of membranous labyrinth, and its image is clearer in many post-processing methods of inner ear water imaging. The contiguous relationship with the surrounding structure is more accurate and can be used to evaluate the shape of the inner ear more effectively.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R764

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