Kress B P J, Griesbeck F, Efinger K, Gottschalk A, Nissen S, Goriup A, Solbach T, Kornhuber A W, Bähren W
Abteilung für Radiologie, Bundeswehrkrankenhaus, Ulm, Germany.
Rofo. 2002 Apr;174(4):426-32. doi: 10.1055/s-2002-25112.
The aim of the study was to assess whether MRI has a prognostic value at an early stage of Bell's palsy.
Prospective, blinded study on 30 patients suffering from Bell's palsy, who came to hospital until the sixth day of illness, to receive high doses steroid therapy. MRI was done on the first day of inpatient treatment as a gradient-echo-sequence with a slice thickness of 0.7 mm before and after i. v. administration of 0.1 mmol GdDTPA/kg weight. The signal intensity increase was evaluated quantitatively by region on interest (ROI). The results were compared to the clinical outcome and the results of electrophysiology.
The examinations of all patients could be evaluated. The 3 patients who developed a chronic facial paralysis were detected by MRI on the first day of inpatient treatment. The patients, who showed MR signs for an unfavorable course, had a highly significant pathologic compound muscle action potential (CMAP) as a result of the electrophysiologic measurement. Rather than using complex measurement procedures it is possible to obtain reliable prognostic information from just one measurement within the Internal auditory canal before and after i. v. administration of contrast.
MRI has a prognostic value at an early stage of the illness. In the clinical setting this measurement is easy to perform, so that it is possible to obtain prognostic information at a stage when causal treatment is still possible.
本研究旨在评估磁共振成像（MRI）在贝尔面瘫早期是否具有预后价值。
对30例贝尔面瘫患者进行前瞻性、盲法研究，这些患者在发病后第六天内入院接受大剂量类固醇治疗。在住院治疗的第一天，静脉注射0.1 mmol钆喷酸葡胺/千克体重前后，采用层厚0.7 mm的梯度回波序列进行MRI检查。通过感兴趣区（ROI）对信号强度增加进行定量评估。将结果与临床结局及电生理结果进行比较。
所有患者的检查均可进行评估。3例发展为慢性面瘫的患者在住院治疗第一天通过MRI被检测出来。MRI显示预后不良征象的患者，电生理测量结果显示复合肌肉动作电位（CMAP）高度异常。在静脉注射造影剂前后，仅对内耳道进行一次测量，无需使用复杂的测量程序，就有可能获得可靠的预后信息。
MRI在疾病早期具有预后价值。在临床环境中，这种测量易于进行，因此在仍有可能进行病因治疗的阶段就能够获得预后信息。
