Isono M, Tanaka H, Murata K, Azuma H
Department of Otorhinolaryngology, Kinki University School of Medicine, Osaka.
Nihon Jibiinkoka Gakkai Kaiho. 1994 Jul;97(7):1229-34.
It is clear, from our clinical experience, that the facial nerve in patients with facial palsy is enhanced on magnetic resonance (MR) imaging after intravenous administration of gadolinium diethylenetriamine. However, some problems with clinical reliability persist. There have been reports that normal facial nerves often show enhancement on MR imaging. We also question whether there are any differences in the degree of enhancement between Bell's palsy and Ramsay Hunt syndrome. To solve these problems, analyses were conducted using a personal computer by means of digital image-processing to measure the gray scale levels of enhanced facial nerves on MR imaging films. Seventeen cases of Bell's palsy, eight cases of Ramsay Hunt syndrome and fourteen normal subjects whose facial nerves showed enhancement on MR imaging were selected for the analyses. The concept of a facial nerve/whole image ratio (F/W ratio), analyzing the degree of enhancement of the facial nerve quantitatively, is introduced in this paper. The F/W ratio is the ratio of the gray scale level of the facial nerve region to the highest gray scale level in the skull at the MR imaging film. When the F/W ratios of these subjects were analyzed, no significant differences were found between Bell's Palsy and Ramsay Hunt syndrome in the degree of enhancement; facial palsy cases showed quantitatively larger F/W ratios than normal subjects.
根据我们的临床经验,很明显,面神经麻痹患者在静脉注射钆二乙烯三胺后,其面神经在磁共振(MR)成像上会出现强化。然而,临床可靠性方面仍存在一些问题。有报道称,正常面神经在MR成像上常常显示强化。我们也质疑贝尔麻痹和拉姆齐·亨特综合征在强化程度上是否存在差异。为了解决这些问题,我们使用个人计算机通过数字图像处理对MR成像胶片上强化面神经的灰度水平进行了分析测量。选择了17例贝尔麻痹患者、8例拉姆齐·亨特综合征患者以及14例面神经在MR成像上显示强化的正常受试者进行分析。本文引入了面神经/全图像比率(F/W比率)的概念,用于定量分析面神经的强化程度。F/W比率是指MR成像胶片上面神经区域的灰度水平与颅骨最高灰度水平的比值。对这些受试者的F/W比率进行分析时,发现贝尔麻痹和拉姆齐·亨特综合征在强化程度上无显著差异;面神经麻痹患者的F/W比率在数量上高于正常受试者。