Li H M, Lyu K, Chen Y, Gao W W, Liu B, Yang A C, Sang C Y, Geng W, Wang B X, Ma G L
Department of Radiology, Fu Xing Hospital, Capital Medical University, Beijing 100038, China.
China-Japan Friendship Hospital, Clinical Medical College of Peking University, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2022 May 24;102(19):1417-1422. doi: 10.3760/cma.j.cn112137-20220113-00087.
To explore the changes of cerebral blood perfusion in patients with unilateral sudden sensorineural hearing loss (SSNHL) by using the three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) technique. The clinical characteristics and ASL data of the 32 patients with unilateral SSNHL were retrospectively collected from November 2020 to June 2021 in Beijing Fuxing Hospital of Capital Medical University, among them, there were 7 males and 25 females, aged from 17 to 73 (44.9±14.4) years. According to the location of SSNHL, they were divided into the left SSNHL (L-SSNHL) group (18 cases) and the right SSNHL (R-SSNHL) group (14 cases). A total of 34 healthy volunteers, which including 14 males and 20 females, aged from 24 to 68 (46.2±14.4) years were enrolled from the local community. The parameter of cerebral blood flow (CBF) of each brain area was obtained using the CereFlow software. The Brainnetome Atlas software package based on MATLAB was used for visualization. The independent-samples test was conducted to compare the difference of cerebral blood perfusion between the unilateral SSNHL group and healthy control (HC) group. Pearson correlation analysis was used to evaluate the correlation between changes in cerebral blood perfusion and clinical scale scores. The CBF of left orbital gyrus part 5, left inferior temporal gyrus part 7, right orbital gyrus part 5, right inferior temporal gyrus part 1, right inferior temporal gyrus part 7, and right parahippocampal gyrus part 3 of the L-SSNHL group were higher than that in the HC group[(49.1±8.8) vs (31.6±10.9)ml·100g·min;(42.8±14.3) vs (27.1±13.6)ml·100g·min;(51.8±9.4) vs (27.2±11.2)ml·100g·min;(38.8±5.7) vs (28.0±9.2)ml·100g·min;(38.4±13.8) vs (23.6±10.3)ml·100g·min;(42.4±9.4) vs (30.1±12.6)ml·100g·min; all <0.05]. The CBF of left superior frontal gyrus part 7 and left middle frontal gyrus part 3 of the L-SSNHL group were lower than that in the HC group[(48.2±7.9) vs (59.3±13.7)ml·100g·min;(46.4±10.3) vs (59.3±16.9)ml·100g·min;all <0.05]. The CBF of left orbital gyrus part 5, right orbital gyrus part 5, right inferior temporal gyrus part 1, and right inferior temporal gyrus part 7 of the R-SSNHL group were higher than that in the HC group[(50.6±7.0) vs (31.6±10.9)ml·100g·min;(50.9±8.8) vs (27.2±11.2)ml·100 g·min;(38.0±7.2) vs (28.0±9.2)ml·100g·min;(35.7±8.5) vs (23.6±10.3)ml·100g·min;all <0.05]; the CBF of right insular part 4 was lower than that in the HC group [(44.2±6.1) vs (54.4±11.3) ml·100 g·min, =0.018]. In the L-SSNHL group, the CBF of left superior frontal gyrus part 7 and right orbital gyrus part 5 were negatively correlated with the VAS score(=-0.83, -0.81, all <0.05), and the CBF of right orbital gyrus part 5 was negatively correlated with the THI score(=-0.75, =0.013). There was no statistically significant correlation between the remaining differences in brain regions and clinical scale scores(all >0.05). Changes in cerebral blood perfusion in multiple brain regions were found in patients with unilateral SSNHL by using the 3D pCASL technique.
采用三维伪连续动脉自旋标记(3D pCASL)技术探讨单侧突发性感音神经性听力损失(SSNHL)患者脑血流灌注的变化。回顾性收集2020年11月至2021年6月首都医科大学附属北京复兴医院32例单侧SSNHL患者的临床资料及动脉自旋标记(ASL)数据,其中男7例,女25例,年龄17~73岁,平均(44.9±14.4)岁。根据SSNHL的发病部位,将患者分为左侧SSNHL(L-SSNHL)组(18例)和右侧SSNHL(R-SSNHL)组(14例)。另选取34名健康志愿者,其中男14例,女20例,年龄24~68岁,平均(46.2±14.4)岁,来自当地社区。使用CereFlow软件获取每个脑区的脑血流量(CBF)参数。基于MATLAB的脑网络图谱软件包用于可视化。采用独立样本检验比较单侧SSNHL组与健康对照组(HC)脑血流灌注的差异。采用Pearson相关分析评估脑血流灌注变化与临床量表评分之间的相关性。L-SSNHL组左侧眶回5区、左侧颞下回7区、右侧眶回5区、右侧颞下回1区、右侧颞下回7区及右侧海马旁回3区的CBF高于HC组[(49.1±8.8)比(31.6±10.9)ml·100g·min;(42.8±14.3)比(27.1±13.6)ml·100g·min;(51.8±9.4)比(27.2±11.2)ml·100g·min;(38.8±5.7)比(28.0±9.2)ml·100g·min;(38.4±13.8)比(23.6±10.3)ml·100g·min;(42.4±9.4)比(30.1±12.6)ml·100g·min;均P<0.05]。L-SSNHL组左侧额上回7区及左侧额中回3区的CBF低于HC组[(48.2±7.9)比(59.3±13.7)ml·100g·min;(46.4±10.3)比(59.3±16.9)ml·100g·min;均P<0.05]。R-SSNHL组左侧眶回5区、右侧眶回5区、右侧颞下回1区及右侧颞下回7区的CBF高于HC组[(50.6±7.0)比(31.6±10.9)ml·100g·min;(50.9±8.8)比(27.2±11.2)ml·100g·min;(38.0±7.2)比(28.0±9.2)ml·100g·min;(35.7±8.5)比(23.6±10.3)ml·100g·min;均P<0.05];右侧岛叶4区的CBF低于HC组[(44.2±6.1)比(54.4±11.3)ml·100g·min,P=0.018]。在L-SSNHL组中,左侧额上回7区及右侧眶回5区的CBF与视觉模拟评分(VAS)呈负相关(r=-0.83、-0.81,均P<0.05),右侧眶回5区的CBF与耳鸣 handicap 量表(THI)评分呈负相关(r=-0.75,P=0.013)。其余脑区差异与临床量表评分之间无统计学显著相关性(均P>0.05)。采用3D pCASL技术发现单侧SSNHL患者多个脑区的脑血流灌注发生了变化。