非全麻下感音神经性耳聋患儿行束扫技术磁共振成像的可行性研究

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婴幼儿的影像学检查有时需要全身麻醉下进行，因为婴幼儿哭闹不配合会影响影像结果的质量，影响诊断和外科手术计划的制定和执行。但过早暴露于全身麻醉可能损害大脑发育，影响认知功能和学习能力，这的确是两难的选择。优化检查技术是否可以减少对全身麻醉的需求也是一个很好的突破口。

摘要译文

非全麻下感音神经性耳聋患儿行束扫技术磁共振成像的可行性研究

目的：探讨非全身麻醉（GA）下感音神经性耳聋（SNHL）婴幼儿行磁共振成像（MRI）检查的可行性。

研究设计：回顾性研究。

单位：儿科三级护理医院。

患者：包括2016年6月至2019年4月期间使用束扫技术MRI检查的单侧或双侧SNHL患儿。

主要观察指标：主要结果是临床有用影像的比例。

结果：我们回顾了21例行束扫技术MRI检查评估SNHL的婴儿。MRI检查时患者的平均年龄为10周（范围：6-25周）。其中38%（8/21）例出现运动伪影。86%（18/21）例具备足够的诊断质量和/或足以制定外科计划植入人工耳蜗。3例（14%）患者需要用GA重复成像，因为最初的图像没有临床意义。所有需要GA的患者都为单侧SNHL。所有双侧SNHL患者均成功地接受了非GA的MRI检查。

结论：我们的研究结果表明，在大多数被诊断为SNHL的婴幼儿中，使用束扫技术MRI检查是可行的。这有助于尽早确定人工耳蜗的候选资格，减少暴露于GA的风险，并降低医疗成本。

原文摘要

The Feasibility of Magnetic Resonance Imaging Without General Anesthesia Using the "Bundle and Scan" Technique for Infants With Sensorineural Hearing Loss

Objective: The purpose of this study is to determine the feasibility of magnetic resonance imaging (MRI) without general anesthesia (GA) for infants being evaluated for sensorineural hearing loss (SNHL) using the bundle and scan technique.

Study design: Retrospective study.

Setting: Pediatric tertiary care hospital.

Patients: All infants who underwent MRI using the bundle and scan technique as part of the diagnostic workup for unilateral or bilateral SNHL between June 2016 to April 2019 were included.

Main outcome measure: The primary outcome was the proportion of clinically useful images produced.

Results: We reviewed 21 bundle and scan MRI examinations in infants being evaluated for SNHL. Patients had a median age of 10 (range: 6-25) weeks at the time of MRI. Motion artifact was noted in 38% (8/21) of cases. Eighty-six percent (18/21) of the magnetic resonance images produced using the bundle and scan technique were of diagnostic quality and/or sufficient for surgical planning for cochlear implantation. Repeat imaging with GA was required for three cases (14%) as the initial images were not clinically useful. All patients requiring GA had unilateral SNHL. All patients with bilateral SNHL successfully underwent MRI without GA using the bundle and scan technique.

Conclusion: The results of our study demonstrate that it is feasible to perform MRI using the bundle and scan technique in the majority of young infants being evaluated for SNHL. This has the potential to help determine cochlear implant candidacy earlier, reduce exposure to GA, and reduce healthcare costs.

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