张宏,邬小平,银小辉,高明,董季平,马鸣岳.高分辨率CT联合MR T2-DRIVE序列诊断儿童蜗神经发育不良[J].中国介入影像与治疗学,2020,17(5):275-279
高分辨率CT联合MR T2-DRIVE序列诊断儿童蜗神经发育不良
High-resolution CT combined MR T2-DRIVE sequence imaging in diagnosis of children cochlear nerve dysplasia
投稿时间:2019-11-02  修订日期:2020-03-10
DOI:10.13929/j.issn.1672-8475.2020.05.005
中文关键词:  前庭蜗神经疾病  蜗神经  体层摄影术,X线计算机  磁共振成像  儿童
英文关键词:vestibulocochlear nerve diseases  cochlear nerve  tomography, X-ray computed  magnetic resonance imaging  child
基金项目:陕西省社会发展科技攻关项目(2016SF-129)。
作者单位E-mail
张宏 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
邬小平 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
银小辉 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
高明 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
董季平 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
马鸣岳 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003 mmy_2005@163.com 
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中文摘要:
      目的 探讨高分辨率CT(HRCT)联合MR T2-DRIVE序列对儿童蜗神经发育不良(CND)的诊断价值。方法 回顾性分析43例CND患儿(单侧28例、双侧15例)的HRCT及MR T2-DRIVE序列图像,分别测量患耳(58耳)及正常耳(28耳)蜗神经管(CNC)直径及蜗神经直径。采用Spearman相关性分析CNC直径与蜗神经直径的相关性。结果 43例CND患儿中患耳58耳、正常耳28耳;单纯CND 27耳,伴其他内耳畸形31耳。HRCT示CNC狭窄45耳,CNC封闭或缺如13耳;内听道狭窄15耳,其中CNC狭窄12耳、闭锁2耳、缺如1耳。MRI示面神经形态走行异常7耳,前庭上下神经缺如1耳、纤细1耳;在内听道狭窄15耳中前庭蜗神经缺如8耳、纤细3耳、正常4耳。58患耳中,7耳HRCT及MRI示CNC发育正常。CND患耳的CNC直径、蜗神经直径均小于正常耳(P均=0.001),单纯CND患耳与合并其他内耳畸形CND患耳间CNC直径及蜗神经直径差异均无统计学意义(P=0.185、0.140)。全部86耳的CNC直径与蜗神经直径呈正相关(rs=0.773,P<0.001)。以CNC直径=1.5 mm为截断值,其诊断CND的敏感度为84.48%(49/58)、特异度100%(28/28)、阳性预测值100%(49/49)、阴性预测值75.68%(28/37)。结论 HRCT联合MR T2-DRIVE序列可为诊断儿童CND提供参考依据。
英文摘要:
      Objective To investigate the value of high-resolution CT (HRCT) combined with MR T2-DRIVE in diagnosis of cochlear nerve dysplasia (CND) of children. Methods HRCT and MR T2-DRIVE image data of 43 children (28 unilateral and 15 bilateral) with CND were retrospectively analyzed. The diameters of cochlear nerve canal (CNC) and cochlear nerve were measured with HRCT and T2-DRIVE,respectively. The correlation between CNC diameter and cochlear nerve diameter was analyzed by using Spearman correlation. Results A total of 58 diseased ears, including 27 pure CND ears and 31 CND accompanied with malformation of inner ear ones, as well as 28 normal ears were found among 43 CND children. HRCT showed CNN stenosis in 45 ears, CNC atresia or absence in 13 ears, internal auditory canal stenosis in 15 ears, including CNC stenosis 12 ears, CNC atresia 2 ears and CNN absence 1 ear. MRI showed abnormal facial nerve morphology in 7 ears, vestibular nerve absence in 1 ear and slender in 1 ear. Among 15 ears of internal auditory canal stenosis, vestibulocochlear nerve was absence in 8 ears and slender in 3 ears, while was normal in 4 ears. Among 58 diseased ears, CNC was demonstrated normal on both HRCT and MRI in 7 ears. The diameters of CNC and cochlear nerve of CND ears were all smaller than those of normal ears (both P=0.001), while no statistically difference of diameters of CNC and cochlear nerve between pure CND ears and CND accompanied with malformation of inner ear ones (P=0.185, 0.140). CNC diameter of all 86 ears was positively correlated with diameter of cochlear nerve (rs=0.773, P<0.001). Taken CNC diameter=1.5 mm as cut-off value, the sensitivity, specificity, positive predictive value and negative predictive value for diagnosis of CND was 84.48% (49/58), 100% (28/28), 100% (49/49) and 75.68% (28/37), respectively. Conclusion HRCT combined with MR T2-DRIVE can provide diagnostic references for CND of children.
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