From the Department of Radiology (M.S.C.), Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Departments of Otorhinolaryngology-Head and Neck Surgery (W.R.C., H.-Y.J., J.H.K.).
AJNR Am J Neuroradiol. 2018 Mar;39(3):532-537. doi: 10.3174/ajnr.A5491. Epub 2017 Dec 21.
Although the olfactory bulb volume as assessed with MR imaging is known to reflect olfactory function, it is not always measured during olfactory pathway assessments in clinical settings. We aimed to evaluate the utility of visual olfactory bulb atrophy and neuropathy analyses using MR imaging in patients with olfactory dysfunction.
Thirty-four patients who presented with subjective olfactory loss between March 2016 and February 2017 were included. Patients underwent a nasal endoscopic examination, olfactory testing with the Korean Version of the Sniffin' Sticks test, and MR imaging. All patients completed the Sino-Nasal Outcome Test and Questionnaire of Olfactory Disorders. Olfactory bulb atrophy and neuropathy were evaluated on MR images by 2 head and neck radiologists.
The etiology of olfactory loss was chronic rhinosinusitis with/without nasal polyps in 15 (44.1%) patients, respiratory viral infection in 7 (20.6%), trauma in 2 (5.9%), and idiopathic in 10 (29.4%) patients. Although 10 (29.4%) of the 34 patients were normosmic according to the Sniffin' Sticks test, their scores on the other tests were like those of patients who were hyposmic/anosmic according to the Sniffin' Sticks test. However, the detection rate of olfactory bulb atrophy was significantly higher in patients with hyposmia/anosmia than it was in patients with normosmia ( = .002). No difference in olfactory bulb neuropathy was identified among patients with normosmia and hyposmia/anosmia ( = .395).
MR imaging evaluations of olfactory bulb atrophy can be used to objectively diagnose olfactory dysfunction in patients with subjective olfactory loss.
虽然磁共振成像（MR）评估的嗅球体积已知可反映嗅觉功能，但在临床嗅路评估中并不总是进行测量。我们旨在评估使用 MR 成像评估嗅觉功能障碍患者的视觉嗅球萎缩和神经病变分析的效用。
纳入 2016 年 3 月至 2017 年 2 月期间因主观嗅觉丧失就诊的 34 例患者。患者接受了鼻内镜检查、韩国版 Sniffin' Sticks 嗅觉测试和 MR 成像检查。所有患者均完成了 Sino-Nasal Outcome Test 和嗅觉障碍问卷。由 2 名头颈部放射科医生在 MR 图像上评估嗅球萎缩和神经病变。
嗅觉丧失的病因是慢性鼻-鼻窦炎伴/不伴鼻息肉（15 例，44.1%）、呼吸道病毒感染（7 例，20.6%）、外伤（2 例，5.9%）和特发性（10 例，29.4%）。尽管 34 例患者中有 10 例（29.4%）根据 Sniffin' Sticks 测试为正常嗅觉，但他们在其他测试中的得分与根据 Sniffin' Sticks 测试为嗅觉减退/嗅觉丧失的患者相似。然而，嗅觉减退/嗅觉丧失患者的嗅球萎缩检出率明显高于嗅觉正常患者（=0.002）。嗅觉正常和嗅觉减退/嗅觉丧失患者之间的嗅球神经病变无差异（=0.395）。
MR 成像评估嗅球萎缩可用于客观诊断有主观嗅觉丧失的嗅觉功能障碍患者。
