Mark A S, Seltzer S, Nelson-Drake J, Chapman J C, Fitzgerald D C, Gulya A J
Department of Radiology, Washington Hospital Center, Washington, DC 20010.
Ann Otol Rhinol Laryngol. 1992 Jun;101(6):459-64. doi: 10.1177/000348949210100601.
Sudden deafness with or without vertigo presents a difficult diagnostic problem. This article describes 12 patients with enhancement of the cochlea and/or vestibule on gadolinium-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (MRI), correlating the enhancement with the auditory and vestibular function. All patients were studied with T2-weighted axial images taken through the whole brain, enhanced 3-mm axial T1-weighted images taken through the temporal bone, and enhanced T1-weighted sagittal images taken through the whole brain. Cochlear enhancement on the side of hearing loss was found in all the patients. The vestibular enhancement correlated with both subjective vestibular symptoms and objective measures of vestibular function on electronystagmography. In 2 patients, the resolution of symptoms 4 to 6 months later correlated with resolution of the enhancement on MRI. No labyrinthine enhancement was seen in a series of 30 control patients studied with the same MRI protocol. Labyrinthine enhancement in patients with auditory and vestibular symptoms is a new finding and is indicative of labyrinthine disease. While abnormalities on electronystagmograms and audiograms are nonspecific and only indicate a sensorineural problem, enhanced MRI may separate patients with retrocochlear lesions, such as acoustic neuromas, from those in whom the abnormal process is in the labyrinth or the brain.
伴有或不伴有眩晕的突发性耳聋是一个诊断难题。本文描述了12例在钆-二乙三胺五乙酸增强磁共振成像（MRI）上出现耳蜗和/或前庭强化的患者，并将这种强化与听觉和前庭功能相关联。所有患者均接受了全脑T2加权轴位图像、颞骨3毫米增强T1加权轴位图像以及全脑增强T1加权矢状位图像的检查。所有患者听力损失侧均发现耳蜗强化。前庭强化与主观前庭症状以及眼震电图检查的前庭功能客观指标均相关。在2例患者中，4至6个月后症状的缓解与MRI上强化的消退相关。在采用相同MRI检查方案的30例对照患者中未发现迷路强化。伴有听觉和前庭症状患者的迷路强化是一项新发现，提示迷路疾病。虽然眼震电图和听力图异常是非特异性的，仅表明存在感觉神经性问题，但增强MRI可将患有蜗后病变（如听神经瘤）的患者与病变位于迷路或脑部的患者区分开来。
