论文部分内容阅读
目的探讨正常面神经与Bell面瘫面神经各节段的强化方式。方法选取17例临床诊断为Bell面瘫的患者为面瘫组,12例年龄相当的无面神经症状而由于其他脑部病变前来做脑部MR增强的患者为正常面神经对照组。面瘫组与正常组均进行横轴位快速三维扰相梯度回波序列(3D-FSPGR)T_1WI平扫及增强、横轴位快速自旋回波序列(FSE)T_2WI,横轴位稳态采集快速成像序列(FIESTA)。将面神经分为用于评估强化程度的5个节段,并对各节段面神经强化程度进行0~3级的分级标识。结果面瘫组76.5%(13/17)患侧面神经内听道底段强化,88.2%(15/17)患侧面神经迷路段强化,而健侧面神经此两段强化率分别为17.6%(3/17)、11.8%(2/17);健侧与患侧的膝状神经节强化率均为70.1%,但是强化程度却大不相同;35.3%(6/17)患侧面神经鼓室段强化,29.4%(5/17)健侧面神经鼓室段强化;41.2%(7/17)患侧面神经乳突段强化,35.3%(6/17)健侧面神经该段强化。正常面神经对照组双侧正常面神经强化节段及强化程度均一致。其中膝状神经节75%(9/12),鼓室段16.7%(2/12),乳突段50%(6/12),内听道段和迷路段均为8.3%(1/12)。结论正常面神经膝状神经节最易强化,且各节段强化程度均为双侧对称性;Bell面瘫患侧面神经较对侧均有异常强化节段,且易见于内听道段底段,迷路段及膝状神经节。
Objective To investigate the enhancement of the facial nerve in Bell facial palsy with normal facial nerve. Methods Seventeen patients with facial paralysis diagnosed as Bell palsy were selected as normal facial nerve control group. Twelve age-matched facial-free neurological symptoms and MR-positive brain lesions were obtained from other brain lesions. The facial paralysis group and the normal group were subjected to 3D-FSPGR T_1WI scan and enhancement, transverse echocardiographic fast spin echo sequence (TFE) T_2WI, horizontal axis position acquisition of fast imaging Sequence (FIESTA). The facial nerve was divided into five segments for assessing the degree of enhancement, and the level of facial nerve enhancement of each segment 0 to 3 levels of identification. Results 76.5% (13/17) of the patients with facial paralysis had enhancement of the auditory base of the lateral nerves, 88.2% (15/17) of them had enhancement of the lateral facial nerve, while those of the healthy side were enhanced by 17.6% (3 / 17) and 11.8% (2/17) respectively. The enhancement rates of both genic and ipsilateral geniculate ganglion were 70.1%, but the degree of enhancement was very different. 35.3% (6/17) 29.4% (5/17) of the contralateral facial tympanosclerosis, 41.2% (7/17) of the contralateral papillary telangiectasia, and 35.3% (6/17) of the contralateral facial nerves. Normal facial nerve control group bilateral normal facial nerve enhancement segment and the degree of enhancement are the same. Among them, 75% (9/12) of the geniculate ganglion, 16.7% (2/12) of the tympanic segment, 50% (6/12) of the mastoid segment and 8.3% (1/12) of the internal auditory canal and the lost segment . Conclusions The normal facial nerve in the geniculate nerve can be easily strengthened and the degree of enhancement of each segment is bilateral symmetry. The facial nerve in Bell facial palsy has abnormally enhanced segments compared with the contralateral side, and is easily found in the bottom of the internal auditory canal segment, Segmental and geniculate ganglion.