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目的 探讨听性脑干反应 (ABR)在听神经瘤诊断上的实际应用价值。方法 回顾性分析 10 5例经手术证实为听神经瘤患者ABR的各项指标 ,以及它与肿瘤体积大小的关系。结果 听神经瘤直径≥ 1、<2cm时 ,ABRⅠ波到Ⅴ波的完全出现率为 10 0 % (2 2 / 2 2 ) ,其中Ⅰ、Ⅲ、Ⅴ的潜伏期均值分别为 1.6 8、4.19、6 .39ms;两耳V波的潜伏期差均值 (IT5 )为 0 .8ms ;Ⅰ波到Ⅴ波的波间期 (T5 - 1)为 4.71ms。在听神经瘤≥ 2cm、<4cm时 ,ABR的完全出现率为 38% (19/ 5 0 ) ,其中Ⅰ、Ⅲ、Ⅴ波的均值分别为 1.6 1、4.2 6、6 .5 2ms ;IT5为 0 .96ms ;T5 - 1为 4.91ms。在听神经瘤≥ 4cm时 ,ABR的完全出现率仅为 6 .1% (2 / 33) ,其中Ⅰ、Ⅲ、Ⅴ的均值为 1.47、4.79、7.12ms;IT5为 1.2 4ms;T5 - 1为 5 .6 5ms。结论 ABRⅠ波到Ⅴ波的完全出现率与肿瘤大小有关 ;ABRⅤ波的延长、IT5的增加、T5 - 1的延长既可作为听神经瘤早期诊断的依据之一 ,又可间接判断肿瘤瘤体的大小。
Objective To investigate the practical value of auditory brainstem response (ABR) in the diagnosis of acoustic neuroma. Methods A retrospective analysis of 105 cases of surgically confirmed ABR in patients with acoustic neuroma indicators, and its relationship with tumor size. Results The complete appearance rate of ABR Ⅰ wave to Ⅴ wave was 100% (2 2/2 2) when the diameter of acoustic neuroma was ≥ 1 and <2 cm, and the mean latency of Ⅰ, Ⅲ and Ⅴ was 1.6 8, 4.19 and 6 respectively. 39ms. The average latency (Vs) of V wave in both ears was 0.8ms, and the wave interval (T5 - 1) of I wave to V wave was 4.71ms. The complete appearance rate of ABR was 38% (19/50) in acoustic neuroma≥2cm and <4cm, among which the average values of Ⅰ, Ⅲ and Ⅴ waves were 1.6, 1.4 6, 6. 5 2ms respectively; IT5 was 0 .96ms; T5 - 1 is 4.91ms. The complete appearance rate of ABR was only 6.1% (2/33) in patients with acoustic neuroma> 4cm, in which the mean values of Ⅰ, Ⅲ and Ⅴ were 1.47, 4.79 and 7.12ms; IT5 was 1.2ms; T5 - 1 was 5 .6 5ms. Conclusions The complete incidence of ABR Ⅰ wave to Ⅴ wave is related to tumor size. The increase of ABR Ⅴ wave, increase of IT5 and extension of T5 - 1 can be used as the basis of early diagnosis of acoustic neuroma and indirect judgment of tumor size .