Evaluation of the early phase of Bell's palsy using 3 T MRI
Evaluation of the early phase of Bell's palsy using 3 T MRI
复制标题
DOI：
10.1007/s00405-011-1498-x
复制
发表时间：
2011-10-01
影响因子：
2.6
通讯作者：
Guntinas-Lichius, Orlando
中科院分区：
文献类型：
--
作者：
Burmeister, Hartmut Peter;Baltzer, Pascal Andreas Thomas;Guntinas-Lichius, Orlando
这项关于贝尔麻痹的前瞻性研究调查了3 T MRI作为诊断工具的价值，以评估面神经节段的病理生理学变化（即水肿），以及区分症状发作后3天内完全恢复的患者与不完全恢复的高风险患者的可能性。对于这项机构审查委员会批准的调查，30名贝尔麻痹患者（14名男性，16名女性，平均年龄44岁）接受了桥脑小脑角对比前后3 T MRI检查。进行T1加权成像（TR 20.0 ms，TE 2.46 ms，各向同性体素尺寸：0.6 mm）。在健康侧和瘫痪侧进行感兴趣区域测量。为了获得标准化值，将信号强度增加百分比（SIIP）值除以健康侧的对侧结果。使用Wilcoxon和Mann-Whitney U检验比较检查神经节段的信号强度测量值，并将其与House-Brackmann评分分类的临床结果相关联。病变侧增强前后耳道前段信号明显增强（P < 0.001）。SIIP在外耳道前段高于膝状神经节（P < 0.001）。相关分析显示信号强度测量值与临床表现或3个月后早期恢复率之间无相关性（P > 0.05）。根据我们的研究结果，早期麻痹相关的病理生理变化，在面神经外耳道前段也可能与积累的蛋白质，而不仅仅是水肿。然而，造影剂增强定量不适合作为区分不同预后组的诊断工具。
This prospective study on Bell's palsy investigated the value of 3 T MRI as a diagnostic tool to evaluate pathophysiological changes (i.e. edema) of facial nerve segments and the possibility to differentiate patients with high risk for incomplete recovery from patients who recover completely within 3 days after symptoms onset. For this institutional review board approved investigation, thirty patients (14 male, 16 female, mean age 44 years) with Bell's palsy underwent pre and postcontrast 3 T MRI of the cerebellopontine angle. T1-weighted imaging was performed (TR 20.0 ms, TE 2.46 ms, isotropic voxel size: 0.6 mm). Region-of-interest measurements were performed on the healthy and paralyzed side. To obtain normalized values, signal intensity increase percentage (SIIP) values were divided by contralateral results of the healthy side. Signal intensity measurements of examined nerve segments were compared using Wilcoxon and Mann-Whitney U tests and correlated to clinical findings categorized by the House-Brackmann score. The lesion side showed significantly higher signal intensities in the premeatal segment before and after contrast agent administration (P < 0.001). SIIP was highest in the premeatal segment compared to the geniculate ganglion (P < 0.001). Correlation analyses revealed no association between signal intensity measurements, clinical findings or early recovery rates after 3 months (P > 0.05). According to our results, early palsy-associated pathophysiological changes in the facial nerve premeatal segment might also be related to accumulation of proteins and not exclusively to edema. However, contrast agent enhancement quantification was not suitable as a diagnostic tool to distinguish different prognostic groups.