Yousem D M, Geckle R J, Bilker W, McKeown D A, Doty R L
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
AJR Am J Roentgenol. 1996 Feb;166(2):439-43. doi: 10.2214/ajr.166.2.8553963.
The purpose of this study was to evaluate patients with reduced or no sense of smell since birth for sites of abnormality by MR imaging.
Twenty-five patients who reported no olfactory function since birth were evaluated by olfactory testing, sinonasal endoscopy, and MR imaging. Surface coil and head coil images of the olfactory bulbs, olfactory tracts, subfrontal cortex, and temporal lobes in contiguous 3-mm sections were obtained. Two reviewers determined unilateral olfactory bulb and tract volumes and temporal lobe volumes in two separate sessions. Qualitative grading for olfactory bulb, olfactory tract, olfactory sulcus, subfrontal region, hippocampus, and temporal lobe damage also was performed.
The absence of olfactory bulbs and tracts (68-84%) or the presence of hypoplasia (16-32%) was noted in all cases. Eight individuals had Kallmann's syndrome (hypogonadotropic hypogonadism with anosmia). Temporal and/or frontal lobe volume loss was noted in five individuals and was mild in all but one individual.
Congenital anosmia or hyposmia appears to be an olfactory bulb-olfactory tract phenomenon rather than a cerebral process.
本研究旨在通过磁共振成像（MR）评估自出生起嗅觉减退或丧失的患者的异常部位。
对25例自出生起就无嗅觉功能的患者进行嗅觉测试、鼻窦内窥镜检查和MR成像评估。获取嗅球、嗅束、额叶下皮质和颞叶连续3毫米层面的表面线圈和头部线圈图像。两名评估者在两个独立的阶段分别测定单侧嗅球和嗅束体积以及颞叶体积。还对嗅球、嗅束、嗅沟、额叶下区域、海马体和颞叶损伤进行了定性分级。
所有病例均发现嗅球和嗅束缺如（68 - 84%）或发育不全（16 - 32%）。8例患者患有卡尔曼综合征（伴有嗅觉缺失的低促性腺激素性性腺功能减退）。5例患者出现颞叶和/或额叶体积减小，除1例患者外其余患者均为轻度。
先天性嗅觉缺失或减退似乎是一种嗅球 - 嗅束现象，而非脑部病变。
