突发性耳聋患者内淋巴积水的客观影像检测

摘要

Objective To visualize endolymphatic hydrops (EH) in patients with sudden sensorineural hearing loss (SSHL). Methods We examined patients diagnosed with SSHL in our department, by using gadopentetate dimeglumine (Gd-DTPA) enhanced MRI inner ear imaging. Results A total of 43 SSHL patients were enrolled, with 23 of them having low-tone SSHL and the rest 20 having total SSHL. Among the 23 patients with low-tone SSHL, MRI was positive of EH in 14 patients (1 patient treated with medications before MRI examination), and negative in 9 patients. MRI was positive of EH in only 4 of the 20 patients with total SSHL. Conclusion Our study proves the existence of EH as the underlying pathol-ogy in low-tone SSHL patients. EH in total SSHL may represent idiopathic EH.%目的：应用内耳核磁造影技术检测证实急性突发感音神经性耳聋患者的内淋巴积水的病理学客观证据，并初步探讨影响检测结果的可能因素，以期为临床检查和治疗提供帮助。方法连续选取来我院门诊就医的突发性耳聋（低频型、全聋型）患者作为研究对象，对其鼓室内注射造影剂，24小时后进行内耳核磁成像检查，以了解其是否存在内淋巴积水。结果43例患者（低频聋23例，全聋20例）符合诊断并同意进行内耳核磁造影检查。在低频聋患者之中，14例患者的造影结果显示内淋巴积水，其中1例患者检查前已药物治疗；9例患者未显示内淋巴积水，其中4例病程超过30天，另外5例病程5-17天，检查前已药物治疗。20例全聋患者中4例检测到内淋巴积水。结论本检查证实了急性低频突发聋患者内淋巴积水这一客观病理发生机制，全聋患者发现少数病例存在内淋巴积水，提示可能为内耳原发性积水。