不同3T核磁共振機內(nèi)耳內(nèi)淋巴影像學測定比較研究
發(fā)布時間：2018-11-25 18:47
【摘要】：目的：采用經(jīng)咽鼓管鼓室內(nèi)導入造影劑釓噴酸葡胺稀釋液、內(nèi)耳三維快速液體衰減反轉(zhuǎn)恢復磁共振掃描(three dimensional fluid attenuated inversion recovery magnetic resonance imaging,3D-FLAIR MRI)技術(shù),在正常內(nèi)耳內(nèi)淋巴顯像基礎(chǔ)上,采用客觀統(tǒng)一的內(nèi)淋巴間隙核磁采集和測定方法,探討此方法得出內(nèi)耳內(nèi)淋巴液截面積的測定值是否可廣泛應用于評價臨床對照研究的科學性、準確性和可行性。 方法：將12例正常受試者隨機分成A組6例、B組6例,采用經(jīng)咽鼓管置管中耳腔給藥的方法,在耳內(nèi)窺鏡監(jiān)視下給入稀釋的釓噴酸葡胺,給藥24小時后A組6例在同仁醫(yī)院3T磁共振機(GE, HDX,美國)；B組6例在北京醫(yī)院3T磁共振機(PHILIPS, ACHIEVA,荷蘭)行3D-FLAIR MRI掃描顯影。耳蝸部采用斜矢位蝸軸截取平面,測量耳蝸底轉(zhuǎn)內(nèi)淋巴間隙和總淋巴間隙面積；前庭部采用冠狀位前庭長軸垂直截取平面,測量前庭部內(nèi)淋巴間隙(橢圓囊和球囊的面積之和)和總淋巴間隙。給藥后1周、1個月時進行純音測聽和聲阻抗測試。 結(jié)果：1、12例正常受試者咽鼓管內(nèi)置管時出現(xiàn)一過性刺痛,4例正常受試者給藥過程中出現(xiàn)一過性旋轉(zhuǎn)性眩暈,12例正常受試者出現(xiàn)耳脹悶感,3例正常受試者出現(xiàn)聽力下降,6例正常受試者給藥時出現(xiàn)流水樣耳鳴,1例正常受試者出現(xiàn)咳嗽。上述癥狀均在給藥結(jié)束后5分鐘內(nèi)消失。 2、A組6例與B組6例正常受試者受試耳的內(nèi)耳3D-FLAIR MRI,均可顯示內(nèi)耳的耳蝸、前庭和(或)半規(guī)管的外淋巴間隙廣泛可見造影劑釓增強區(qū)影,可以區(qū)分內(nèi)、外淋巴間隙的邊界和清晰顯像內(nèi)淋巴的情況。 3、A組6例正常受試者的耳蝸和前庭的內(nèi)淋巴間隙評定值分別為0.19±0.04和0.15±0.03；B組6例正常受試者的耳蝸和前庭的內(nèi)淋巴間隙評定值分別為0.31±0.06和0.32±0.05。 A組6例正常受試者和B組6例正常受試者之間耳蝸的內(nèi)淋巴間隙評定值比較無明顯統(tǒng)計學差異(P0.05)；前庭部的內(nèi)淋巴間隙評定值比較無明顯統(tǒng)計學差異(P0.05)。 4、給藥1月后,12例正常受試者復查純音測聽和聲阻抗測試都在正常范圍,與受試前純音測聽和聲阻抗測試結(jié)果相較,未見明顯差異。 結(jié)論：經(jīng)咽鼓管鼓室內(nèi)導入造影劑釓,內(nèi)耳3D-FLAIR MRI,采用客觀統(tǒng)一的內(nèi)淋巴間隙核磁圖像采集和測定方法,得到的內(nèi)淋巴間隙的評定值是具有科學、準確及可比性的,是具有可被廣泛應用于臨床對照研究的方法；本研究為進一步以內(nèi)淋巴積水為主要病理特征的一系列內(nèi)耳病的客觀診斷奠定了必要的基礎(chǔ)及指導治療與預后。正常內(nèi)耳內(nèi)淋巴間隙的客觀評定值的影像學確定,為內(nèi)淋巴積水程度與臨床癥狀嚴重程度的相關(guān)性研究提供了參考基礎(chǔ)。
[Abstract]:Objective: to introduce the contrast agent meglumine gadolpate into the eustachian tube tympanum and restore magnetic resonance imaging (three dimensional fluid attenuated inversion recovery magnetic resonance imaging,3D-FLAIR MRI) technique with 3D fast fluid attenuation inversion in the inner ear. On the basis of endolymphatic imaging of normal inner ear, an objective and unified method of nuclear magnetic resonance (NMR) measurement of endolymphatic space was used to investigate whether this method could be widely used to evaluate the scientificalness of clinical controlled study. Accuracy and feasibility. Methods: 12 normal subjects were randomly divided into two groups: group A (n = 6) and group B (n = 6). 24 hours after administration, 6 patients in group A were treated with 3T magnetic resonance machine (GE, HDX, USA) in Tongren Hospital. Group B (6 cases) were examined by 3D-FLAIR MRI in 3 T magnetic resonance machine (PHILIPS, ACHIEVA, Netherlands) of Beijing Hospital. The cochlear space and total lymphoid space were measured by oblique sagittal axis of cochlea. The long vestibular axis of the vestibular vestibule was used to measure the total lymphatic space (the sum of the area of the elliptical sac and balloon) and the total lymphatic space. Pure tone audiometry and acoustic impedance test were performed 1 week and 1 month after administration. Results: (1) there were transient stinging pain in eustachian tube placement in 12 normal subjects, transient rotational vertigo in 4 normal subjects, ear distention in 12 normal subjects, hearing loss in 3 normal subjects. In 6 cases of normal subjects, fluid-like tinnitus and cough occurred in 1 case of normal subjects. The above symptoms disappeared within 5 minutes after administration. 2The inner ear 3D-FLAIR MRI, of 6 subjects in group A and 6 normal subjects in group B could show the cochlea of the inner ear, and the contrast agent gadolinium enhancement area could be widely seen in the vestibular and / or semicircular perilymphatic space, which could be distinguished from the inner ear. The boundary of the perilymphatic space and clear imaging of the endolymphes. 3 in group A, the assessment values of endolymphatic space in cochlea and vestibule of 6 normal subjects were 0.19 鹵0.04 and 0.15 鹵0.03, respectively. In group B, the assessment values of endolymphatic space in cochlea and vestibule of 6 normal subjects were 0.31 鹵0.06 and 0.32 鹵0.05, respectively. There was no significant difference in the assessment value of endolymphatic space between group A (6 normal subjects) and group B (6 normal subjects) (P0.05), but there was no significant difference between vestibule and vestibule (P0.05). 4. One month after administration, 12 normal subjects were examined in the normal range of pure tone audiometry and acoustic impedance test, and there was no significant difference between pure tone audiometry and acoustic impedance test. Conclusion: through the introduction of gadolinium into the eustachian tube tympanum, the inner ear 3D-FLAIR MRI, adopts objective and unified method of collecting and measuring endolymphatic space nuclear magnetic resonance image. The evaluated value of endolymphatic space is scientific, accurate and comparable. It is a method which can be widely used in clinical controlled study. This study laid a foundation for the objective diagnosis of endolymphatic hydronephrosis, which is the main pathological feature of endolymphatic hydrops, and provided guidance for the treatment and prognosis of endolymphatic hydronephrosis. The imaging determination of the objective assessment value of endolymphatic space in the normal inner ear provides a reference basis for the study of the correlation between the degree of endolymphatic hydrops and the severity of clinical symptoms.
【學位授予單位】：昆明醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R764.04
本文編號：2357076
[Abstract]:Objective: to introduce the contrast agent meglumine gadolpate into the eustachian tube tympanum and restore magnetic resonance imaging (three dimensional fluid attenuated inversion recovery magnetic resonance imaging,3D-FLAIR MRI) technique with 3D fast fluid attenuation inversion in the inner ear. On the basis of endolymphatic imaging of normal inner ear, an objective and unified method of nuclear magnetic resonance (NMR) measurement of endolymphatic space was used to investigate whether this method could be widely used to evaluate the scientificalness of clinical controlled study. Accuracy and feasibility. Methods: 12 normal subjects were randomly divided into two groups: group A (n = 6) and group B (n = 6). 24 hours after administration, 6 patients in group A were treated with 3T magnetic resonance machine (GE, HDX, USA) in Tongren Hospital. Group B (6 cases) were examined by 3D-FLAIR MRI in 3 T magnetic resonance machine (PHILIPS, ACHIEVA, Netherlands) of Beijing Hospital. The cochlear space and total lymphoid space were measured by oblique sagittal axis of cochlea. The long vestibular axis of the vestibular vestibule was used to measure the total lymphatic space (the sum of the area of the elliptical sac and balloon) and the total lymphatic space. Pure tone audiometry and acoustic impedance test were performed 1 week and 1 month after administration. Results: (1) there were transient stinging pain in eustachian tube placement in 12 normal subjects, transient rotational vertigo in 4 normal subjects, ear distention in 12 normal subjects, hearing loss in 3 normal subjects. In 6 cases of normal subjects, fluid-like tinnitus and cough occurred in 1 case of normal subjects. The above symptoms disappeared within 5 minutes after administration. 2The inner ear 3D-FLAIR MRI, of 6 subjects in group A and 6 normal subjects in group B could show the cochlea of the inner ear, and the contrast agent gadolinium enhancement area could be widely seen in the vestibular and / or semicircular perilymphatic space, which could be distinguished from the inner ear. The boundary of the perilymphatic space and clear imaging of the endolymphes. 3 in group A, the assessment values of endolymphatic space in cochlea and vestibule of 6 normal subjects were 0.19 鹵0.04 and 0.15 鹵0.03, respectively. In group B, the assessment values of endolymphatic space in cochlea and vestibule of 6 normal subjects were 0.31 鹵0.06 and 0.32 鹵0.05, respectively. There was no significant difference in the assessment value of endolymphatic space between group A (6 normal subjects) and group B (6 normal subjects) (P0.05), but there was no significant difference between vestibule and vestibule (P0.05). 4. One month after administration, 12 normal subjects were examined in the normal range of pure tone audiometry and acoustic impedance test, and there was no significant difference between pure tone audiometry and acoustic impedance test. Conclusion: through the introduction of gadolinium into the eustachian tube tympanum, the inner ear 3D-FLAIR MRI, adopts objective and unified method of collecting and measuring endolymphatic space nuclear magnetic resonance image. The evaluated value of endolymphatic space is scientific, accurate and comparable. It is a method which can be widely used in clinical controlled study. This study laid a foundation for the objective diagnosis of endolymphatic hydronephrosis, which is the main pathological feature of endolymphatic hydrops, and provided guidance for the treatment and prognosis of endolymphatic hydronephrosis. The imaging determination of the objective assessment value of endolymphatic space in the normal inner ear provides a reference basis for the study of the correlation between the degree of endolymphatic hydrops and the severity of clinical symptoms.
【學位授予單位】：昆明醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R764.04
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