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目的探讨MRI在儿童内耳畸形中的应用价值。方法选择2013年7月至2015年12月在深圳市龙华新区人民医院和北京大学深圳医院诊治的疑似内耳畸形患儿30例(60耳),其中男性13例,女性17例;年龄1~14岁,平均年龄9岁。选择6例内耳正常志愿者(对照组),其中男性3例,女性3例;年龄1~16岁,平均年龄10岁。采用Philips Achieva 1.5 T MRI扫描仪对临床拟诊为感音性神经性耳聋(SNHL)患儿进行蜗神经MRI成像和内耳水成像,正常志愿者进行MRI对照检查。结果 30例患儿中,内耳重型畸形9例(30%)(Michel畸形4例7耳,Mondini畸形2例4耳,蜗神经缺如3例5耳);内耳相对轻型畸形21例(70%)(共腔畸形2例4耳,蜗管发育不全性聋2例4耳,Scheibe型畸形5例10耳,前庭导水管扩大10例19耳,内听道畸形而耳蜗及蜗神经发育正常或不良2例3耳)。其中含有3例两组交叉复合畸形即左右耳分别为重型和相对轻型内耳畸形。结论 MRI较为准确判断患儿内耳畸形、蜗神经发育状况,并可对畸形轻重程度分类,可为人工耳蜗植入适应证与禁忌证提供影像证据,在诊断SNHL中发挥着重要价值。
Objective To investigate the value of MRI in the diagnosis of children’s inner ear deformity. Methods Thirty cases (60 ears) of suspected deformities of the inner ear diagnosed and treated in Longhua New District People’s Hospital of Shenzhen City and Shenzhen Hospital of Peking University from July 2013 to December 2015 were selected, including 13 males and 17 females, aged from 1 to 14 The average age of 9 years old. Six normal volunteers (control group) were selected, including 3 males and 3 females, aged from 1 to 16 years with an average age of 10 years. The Philips Achieva 1.5 T MRI scanner was used for MRI examination of cochlear nerves and inner ear water in children with sensory neuropathy deafness (SNHL). Results Ninety cases (30%) of severe deformities of the inner ear (Michel deformity in 4 cases and 7 ears, Mondini deformity in 2 cases and 4 ears, and cochlear nerve lacking in 3 cases and 5 ears) were obtained in 30 cases. Twenty-one cases (70% ), 2 cases of 4 cases of common cavity malformation, 2 cases of cochlear hypoplasia 2 cases, Scheibe-type deformity 5 cases of 10 cases, vestibular aqueduct enlargement of 10 cases 19 cases of internal auditory canal malformation and cochlear and cochlear nerve development normal or Bad 2 cases 3 ears). Which contains three cases of two groups of cross-sectional deformities that left and right ears were heavy and relatively light inner ear deformity. Conclusion MRI is more accurate in judging the deformity of the inner ear and the development of the cochlear nerve in children, and can classify the degree of deformity. It can provide imaging evidence for cochlear implant indications and contraindications and plays an important role in the diagnosis of SNHL.