Yousem D M, Geckle R J, Bilker W B, McKeown D A, Doty R L
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
AJNR Am J Neuroradiol. 1996 Jun-Jul;17(6):1171-9.
To evaluate the sites of injury in patients with posttraumatic olfactory deficits and to compare damage with findings on clinical olfactory tests.
Twenty-five patients with posttraumatic olfactory dysfunction were examined by means of olfactory testing, endoscopy, and MR imaging. MR surface-coil scans through the olfactory bulbs and tracts and head-coil scans of the temporal lobes were evaluated. Quantitative and qualitative gradings of damage to the olfactory bulbs, tracts, subfrontal region, hippocampus, and temporal lobes were compared with results on tests of odor identification, detection, memory, and discrimination.
Twelve patients were anosmic, eight had severe impairment, and five were mildly impaired. Injuries to the olfactory bulbs and tracts (88% of patients), subfrontal region (60%), and temporal lobes (32%) were found, but these did not correlate well with individual olfactory test scores. Volumetric analysis showed that patients without smell function had greater volume loss in olfactory bulbs and tracts than did those posttraumatic patients who retained some sense of smell. Qualitative and quantitative assessments of damage showed few significant correlations with olfactory tests, probably because of multifocal injuries, primary olfactory nerve damage, and the constraints of a small sample size on the detection of clinically significant differences.
MR imaging shows abnormalities in patients with posttraumatic olfactory dysfunction at a very high rate (88%), predominantly in the olfactory bulbs and tracts and the inferior frontal lobes.
评估创伤后嗅觉减退患者的损伤部位，并将损伤情况与临床嗅觉测试结果进行比较。
对25例创伤后嗅觉功能障碍患者进行嗅觉测试、鼻内镜检查和磁共振成像（MR）检查。对通过嗅球和嗅束的MR表面线圈扫描以及颞叶的头部线圈扫描进行评估。将嗅球、嗅束、额叶下部区域、海马体和颞叶损伤的定量和定性分级与气味识别、检测、记忆和辨别测试结果进行比较。
12例患者嗅觉丧失，8例严重受损，5例轻度受损。发现嗅球和嗅束（88%的患者）、额叶下部区域（60%）和颞叶（32%）有损伤，但这些损伤与个体嗅觉测试分数的相关性不佳。体积分析显示，嗅觉功能丧失的患者嗅球和嗅束的体积损失比仍保留部分嗅觉的创伤后患者更大。损伤的定性和定量评估与嗅觉测试几乎没有显著相关性，这可能是由于多灶性损伤、原发性嗅神经损伤以及样本量小限制了对临床显著差异的检测。
MR成像显示创伤后嗅觉功能障碍患者的异常发生率非常高（88%），主要位于嗅球和嗅束以及额叶下部。
