论文部分内容阅读
目的总结分析面神经病变的影像学检查方法和表现,提高诊断准确性。资料与方法回顾性分析31例经手术病理或临床跟踪随访证实的面神经病变的CT和MRI表现,31例行MR扫描,其中28例行平扫和增强扫描,3例仅行平扫;19例行CT扫描。结果(1)面神经损伤13例,8例行CT扫描,6例显示面神经管骨折,2例表现正常;13例MRI扫描均表现为面神经增粗,其中10例增强扫描显示面神经明显强化。(2)面神经炎14例,7例行CT扫描,1例因岩尖胆脂瘤致面神经管迷路段、前膝部、鼓室段前部骨质破坏,6例面神经管未见异常;14例MRI增强扫描显示面神经节段性异常强化。(3)面神经鞘瘤4例,CT表现为受累面神经管骨质破坏和软组织肿块;MRI表现为面神经节段性增粗,呈长T1、长T2信号,信号不均匀,增强后不均匀强化。经统计学处理,MRI显示颞骨内面神经病变明显优于CT(P<0.01)。结论HRCT可显示面神经管的异常,MRI尤其是MR增强扫描可显示面神经病变的形态、部位、范围及强化表现,有助于病变的诊断和鉴别诊断。
Objective To summarize and analyze the imaging methods and manifestations of facial neuropathy to improve the diagnostic accuracy. Materials and Methods Retrospectively analyzed the CT and MRI findings of 31 cases of facial neuropathy confirmed by surgical pathology or clinical follow-up, 31 cases underwent MR scan, of which 28 cases underwent plain scan and enhanced scan, 3 cases underwent plain scan only, 19 cases CT scan. Results (1) 13 cases of facial nerve injury, 8 cases of CT scan, 6 cases of facial nerve canal fracture showed normal performance in 2 cases; 13 cases of MRI showed facial nerve thickening, of which 10 cases of enhanced scan showed significant enhancement of the facial nerve. (2) 14 cases of facial neuritis, 7 cases of CT scan, 1 case of petrous cholesteatoma caused by facial nerve tube labyrinth, anterior knee, tympanic anterior bone destruction, 6 cases of facial nerve tube no abnormalities; 14 cases MRI enhanced scan showed abnormal facial ganglion enhancement. (3) 4 cases of facial nerve sheath tumor, CT showed involvement of the destruction of the neural tube of the facial nerve and soft tissue mass; MRI showed facial ganglion thickening, showing long T1, long T2 signal, the signal is not uniform, enhanced uneven enhancement. Statistically, MRI showed superior temporal neuropathic pain better than CT (P <0.01). Conclusion HRCT can show the abnormality of facial nerve canal. MRI, especially MR enhanced scan, can show the morphology, location, range and enhancement of facial nerve lesions, which is helpful to the diagnosis and differential diagnosis of the lesions.