Kress B P J, Griesbeck F, Efinger K, Solbach T, Gottschalk A, Kornhuber A W, Bähren W
Department of Radiology, Armed Forces Hospital, Deutsche Bundeswehr, Oberer Eselsberg 40, 89081 Ulm, Germany.
Neuroradiology. 2002 May;44(5):428-33. doi: 10.1007/s00234-001-0738-y. Epub 2002 Feb 16.
Our objective was to assess the prognostic value of measurements of the degree of contrast enhancement of the intratemporal segments of the facial nerve. We prospectively obtained MRI, slice thickness <1 mm of 20 patients with a facial palsy on the first day of inpatient treatment, and measured contrast enhancement of the nerve. The data were compared with compound muscle action potential (CMAP) measurements and the clinical course. Analysis of the initial enabled differentiation of three patients whose palsy was to show no improvement from 17 whose palsy was to resolve as expected. No patient with a poor outcome showed lesser increase in signal in the internal auditory canal, pars tympanica and pars mastoidea than patients who fully recovered. In no patient who had been diagnosed on the basis of the initial MRI as having a "normal" palsy was the amplitude of the (CMAP) reduced to less than 20% that of the normal side. Measurement of contrast enhancement was thus shown to be a prognostic indicator and may provide a basis for a differential treatment of facial palsy.
我们的目的是评估面神经颞内段强化程度测量的预后价值。我们前瞻性地获取了20例面瘫患者住院治疗第一天的MRI，切片厚度<1mm，并测量了神经的强化情况。将数据与复合肌肉动作电位（CMAP）测量结果及临床病程进行比较。对初始数据的分析能够区分出3例面瘫无改善的患者和17例面瘫如期恢复的患者。预后不良的患者在内耳道、鼓室段和乳突段的信号增强程度均未低于完全恢复的患者。在最初MRI诊断为“正常”面瘫的患者中，无一例（CMAP）波幅降低至正常侧的20%以下。因此，强化程度测量被证明是一种预后指标，可为面瘫的个体化治疗提供依据。
