Dumas G, Charachon R, Perret J, Vasdev A, Boulat E, Boubagra K
Clinique ORL, CHU, Hôpital A. Michallon, Grenoble.
Ann Otolaryngol Chir Cervicofac. 1998 May;115(2):59-72.
Twelve cases of vestibular neuritis were investigated in gradient echo MRI with gadolinium. Only 3 severe cases associated with an acoustico facial syndrome (2 cases of herpes zoster oticus and one case after influenzae) demonstrated focal enhancement within the internal auditory canal on post contrast T1 weighted images. This enhancement involved at least 2 differents nerves. These 3 severe cases associating sensory neural hearing loss and facial palsy revealed a meningeal reaction after cerebrospinal fluid examination. The enhancement lasted a long time (up to 10 months) in one case of RAMSAY HUNT syndrome associated with a chronic lymphocytic leukemia. The MRI was able to confirm the anatomical reality of the vestibular neuritis and more precisely of the meningoneuritis and gave arguments for the theory of the polyneuropathy of Adour. Enhancement at MRI seems correlated with the severity of the affection (permanent vestibular areflexia in 3 cases and permanent hearing loss in 1 case).
对12例前庭神经炎患者进行了钆增强梯度回波MRI检查。仅3例与听面综合征相关的严重病例(2例耳带状疱疹和1例流感后病例)在增强后T1加权图像上显示内耳道内局灶性强化。这种强化累及至少2条不同的神经。这3例伴有感音神经性听力损失和面神经麻痹的严重病例在脑脊液检查后显示有脑膜反应。1例与慢性淋巴细胞白血病相关的拉姆齐·亨特综合征患者的强化持续了很长时间(长达10个月)。MRI能够证实前庭神经炎,更确切地说是脑膜神经炎的解剖学实际情况,并为阿杜尔多神经病理论提供了依据。MRI上的强化似乎与病情严重程度相关(3例出现永久性前庭反射消失,1例出现永久性听力损失)。