三维快速液体衰减反转恢复与三维真实重建反转恢复MRI特征对单侧突发性聋疗效评估的价值OA

Objective To investigate the association between imaging findings on three-dimensional fast fluid-attenuated inversion recovery(3D FLAIR)and three-dimensional real reconstruction inversion recovery(3D real IR)MRI sequences and clinical therapeutic efficacy in patients with unilateral sudden sensorineural hearing loss(SSNHL).Methods A total of 87 patients with unilateral SSNHL who underwent inner ear MRI examinations including 3D FLAIR and 3D real IR sequences were retrospectively enrolled.On 3D real IR images,the signal intensities of the cochlea in the affected and contralateral ears,as well as the signal intensity of the medulla oblongata,were measured,and the cochlea-to-medulla(CM)signal intensity ratios were calculated.Meanwhile,changes in high-signal-intensity areas in the affected ear were evaluated on the 3D FLAIR sequence.According to pure-tone audiometry results one month after treatment,patients were divided into an effective group(51 cases)and an ineffective group(36 cases).Independent-samples t tests were used to compare CM values of the affected ear and the contralateral ear,as well as the affected-to-contralateral CM ratio,between the two groups.The chi-square test was used to compare the distribution differences of clinical and imaging data(sex,affected ear,degree of hearing loss,type of hearing loss,and changes in high-signal-intensity areas)between groups.Spearman correlation analysis was performed to assess the relationships between the affected-to-contralateral CM ratio,changes in high-signal-intensity areas,and therapeutic efficacy.Multivariate logistic regression analysis was conducted to identify factors influencing ineffective treatment outcomes in unilateral SSNHL.Results The cochlear signal intensity and CM ratio of the affected ear were significantly higher than those of the contralateral ear(P<0.05).The CM values of the contralateral ear and affected ear,as well as the affected-to-contralateral CM ratio,were all significantly higher in the ineffective group than in the effective group(all P<0.05).Spearman correlation analysis showed a significant negative correlation between the affected-to-contralateral CM ratio and therapeutic efficacy(r=-0.786,P<0.001).Significant differences in changes of high-signal-intensity areas were observed between the two groups(P<0.001):the effective group was predominantly characterized by signal normalization or absorption,whereas the ineffective group mainly showed non-absorbed signals.Changes in high-signal-intensity areas were also negatively correlated with therapeutic efficacy(r=-0.430,P<0.001).Multivariate logistic regression analysis indicated that the affected-to-contralateral CM ratio and changes in high-signal-intensity areas were independent risk factors for ineffective treatment(both P<0.05).Conclusion An increased affected-to-contralateral CM ratio and persistent abnormal high-signal-intensity areas are indicative of poor therapeutic outcomes.MRI findings on 3D FLAIR and 3D real IR sequences are correlated with treatment efficacy in patients with unilateral SSNHL and constitute independent influencing factors for ineffective treatment.These imaging parameters may serve as potential reference indicators for evaluating prognosis and therapeutic efficacy in SSNHL.