目的:建立一个病例系列,其中后半规管(SCC)中磁共振流体信号强度的损失与临床和视频头脉冲测试的功能缺陷相对应,很可能是运河纤维化或阻塞的结果。
方法:三例磁共振成像(MRI)显示其后部SCC的T2加权信号强度丢失,对应于该管的前庭无力。
方法:所有患者都接受了全面的神经耳科检查。前庭眼反射使用临床头部脉冲测试(cHIT)进行评估,并用视频头部脉冲测试进行量化。所有患者的MRI均使用1.5或3T扫描仪上的内听道钆增强MRI的临床方案获得,所有这些都包括高分辨率,膜迷宫的T2加权成像。
方法:将MRI表现与相应后部SCC的前庭无力相关。
结果:受试者1在左外侧和左后侧SCC显示异常vHIT。MRI显示整个左后SCC以及上SCC后肢的T2信号强度丧失。受试者2显示出孤立的功能丧失(cHIT)和左后SCC追赶扫视(vHIT)的低增益。MRI显示左后SCC上段T2信号强度丢失,以及上SCC的后肢。受试者3在cHIT和vHIT上显示左后SCC的追赶扫视,在MRI上显示整个左后SCC的T2信号强度丧失和双侧外侧SCC的部分丧失。
结论:在本案例系列中,后SCC功能丧失与前庭功能测试和高分辨率相关,T2加权MRI检查结果,可能与后SCC的纤维化有关。
OBJECTIVE: To establish a
case series where loss of magnetic resonance fluid signal intensity in the posterior semicircular canal (SCC) corresponded with a functional deficit on clinical and video head impulse testing, and most likely a result of canal fibrosis or obstruction.
METHODS: Three patients with an magnetic resonance imaging (MRI) showing loss of T2-weighted signal intensity in their posterior SCC corresponding to a vestibular weakness in that canal.
METHODS: All patients underwent a comprehensive neuro-otologic examination. Vestibulo-ocular reflex was evaluated using clinical head impulse testing (cHIT) and quantified with video head impulse testing. MRI for all patients was obtained using clinical protocols for gadolinium-enhanced MRI of the internal auditory canal on 1.5 or 3 T scanners, which all included high-resolution, heavily T2-weighted imaging of the membranous labyrinth.
METHODS: Correlation of MRI findings with vestibular weakness in the corresponding posterior SCC.
RESULTS: Subject 1 showed abnormal vHIT in the left lateral and left posterior SCCs. MRI showed loss of T2 signal intensity of the entire left posterior SCC as well as in the posterior limb of the superior SCC. Subject 2 showed isolated loss of function (cHIT) and low gain with catch-up saccade (vHIT) of the left posterior SCC. MRI showed loss of T2 signal intensity of the superior portion of the left posterior SCC, as well as in the posterior limb of the superior SCC. Subject 3 showed catch-up saccades of the left posterior SCC on cHIT and vHIT and loss of T2 signal intensity of the entire left posterior SCC and partial loss of bilateral lateral SCC on MRI.
CONCLUSIONS: In this
case series, loss of posterior SCC function correlated with vestibular function testing and high-resolution, T2-weighted MRI findings, perhaps related to fibrosis of the posterior SCC.