*Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs †Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Japan.
Otol Neurotol. 2017 Dec;38(10):1523-1527. doi: 10.1097/MAO.0000000000001605.
To investigate the usefulness of magnetic resonance imaging (MRI) including three-dimensional (3D) sequences in the differentiation between Bell's palsy (BP) and Ramsay Hunt syndrome (RHS).
A prospective study.
Tertiary care center.
Twenty patients: 15 patients with BP and five patients with RHS.
Diagnostic.
Clinical diagnosis (BP or RHS).
The presence of hyperintensity on 3D-fluid-attenuated inversion recovery sequence (3D-FLAIR) and enhancement on gadolinium-enhanced (CE)-3D-FLAIR and CE-3D-T1-weighted image (3D-T1WI) along the internal auditory canal (IAC) wall were significantly associated with RHS (p < 0.05). Hyperintensity in the inner ear was observed on pre- and postcontrast 3D-FLAIR, and enhancement of the cranial nerve (CN)-VIII was observed only on CE-3D-FLAIR. The presence of these findings also showed significant relationships with RHS (p < 0.05). Moreover, thickening of the CN-VII in the fundus of the IAC in 3D-constructive interference on steady state sequence (3D-CISS) also showed a significant association with RHS (p < 0.05). In contrast, the presence of hyperintensity of the CN-VII in the fundus of the IAC on 3D-FLAIR did not demonstrate a significant relationship (p = 0.95), and enhancement in this region was observed in all cases on CE-3D-FLAIR and gadolinium-enhanced-three-dimensional-T1-weighted gradient echo sequence (CE-3D-T1WI).
3D MRI sequences are useful for differentiating RHS from BP. In particular, the enhancement in the CN-VIII and/or along the IAC wall are valuable findings, and CE-3D-FLAIR is the most useful sequence to evaluate these findings. Thickening of the CN-VII on 3D-CISS is also an important finding.
探讨磁共振成像（MRI）包括三维（3D）序列在贝尔面瘫（BP）与 Ramsay Hunt 综合征（RHS）鉴别诊断中的作用。
前瞻性研究。
三级医疗中心。
20 例患者：15 例 BP 患者和 5 例 RHS 患者。
诊断。
临床诊断（BP 或 RHS）。
3D 液体衰减反转恢复序列（3D-FLAIR）上的高信号和钆增强（CE）3D-FLAIR 及 CE-3D-T1WI 沿内听道（IAC）壁的增强与 RHS 显著相关（p<0.05）。内耳在增强前后的 3D-FLAIR 上呈高信号，而仅在 CE-3D-FLAIR 上观察到颅神经（CN）VIII 的增强。这些表现的存在也与 RHS 有显著关系（p<0.05）。此外，在 3D 稳态干扰序列（3D-CISS）中 IAC 底部 CN-VII 的增厚也与 RHS 有显著关联（p<0.05）。相反，IAC 底部 CN-VII 的高信号在 3D-FLAIR 上的存在与 RHS 无显著关系（p=0.95），而在该区域的增强在所有病例中均在 CE-3D-FLAIR 和钆增强三维 T1WI（CE-3D-T1WI）上观察到。
3D MRI 序列有助于鉴别 RHS 与 BP。特别是 CN-VIII 的增强和/或沿 IAC 壁的增强是有价值的发现，CE-3D-FLAIR 是评估这些发现的最有用序列。3D-CISS 上 CN-VII 的增厚也是一个重要的发现。
