Marsot-Dupuch K, Bousson V, Cabane J, Tubiana J M
Department of Radiology, Hôpital Saint-Antoine, Paris, France.
AJNR Am J Neuroradiol. 1995 Nov-Dec;16(10):2093-100.
To look for central nervous system abnormalities as possible causes of intractable hiccups.
Of a series of 50 patients with chronic (ie, lasting more than 48 hours) hiccups, a prospective study identified a subgroup of 9 patients with no clinical or gastroesophageal abnormalities (according to endoscopy, pH monitoring and manometry). We performed in all 9 patients brain and upper cervical cord MR examination with precontrast and postcontrast T1- and T2-weighted sequences. A study of the last cranial nerves was done with thin T2-weighted imaging (constructive interference in a steady state sequence). The cervical cord and parapharyngeal space were systematically explored using coronal T2- and sagittal T1-weighted imaging.
Five of these 9 patients had definite MR abnormalities located in the temporal lobe (3 cases), cerebellopontine angle (1 case), or areas of high signal intensity compatible with demyelination (1 case). The relationship between hiccups and infratentorial abnormalities in 2 cases was doubtful (vascular loop and prominent posterior condylar canal). MR findings in 2 cases were considered normal.
Brain MR is a useful investigation in patients with chronic hiccups when gastroesophageal lesions are either excluded or too mild to account for an intractable hiccup.
寻找可能导致顽固性呃逆的中枢神经系统异常。
在一系列50例慢性（即持续超过48小时）呃逆患者中，一项前瞻性研究确定了一个亚组，其中9例患者无临床或胃食管异常（根据内镜检查、pH监测和测压）。我们对所有9例患者进行了脑部和上颈髓的磁共振检查，采用了对比剂前和对比剂后的T1加权和T2加权序列。通过薄层T2加权成像（稳态进动快速成像序列）对最后几对颅神经进行研究。使用冠状面T2加权成像和矢状面T1加权成像对颈髓和咽旁间隙进行系统检查。
这9例患者中有5例在颞叶（3例）、桥小脑角（1例）或与脱髓鞘相符的高信号强度区域（1例）存在明确的磁共振异常。2例患者中呃逆与幕下异常之间的关系存疑（血管襻和明显的后髁管）。2例患者的磁共振检查结果被认为正常。
当胃食管病变被排除或过于轻微不足以解释顽固性呃逆时，脑部磁共振检查对慢性呃逆患者是一项有用的检查。
