Article record

耳蜗蜗轴作为脑脊液流与淋巴液之间液体交换的功能性门户

The cochlear modiolus as a functional gateway for fluid exchange between cerebrospinal flow and perilymph.

临床研究耳科IF 2.6Q1

文献信息

PMID	42907306
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Yu-Fen Wang 查看其他 3 位作者 Yi-Ho Young；Mei-Chi Chen；Wen-Chau Wu
作者单位	Department of Medical Imaging, National Taiwan University Hospital, No. 7, Zhong-Shan S. Road, Taipei, 100, Taiwan. 查看其他 2 条单位信息 Department of Otolaryngology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao District, New Taipei City, 220, Taiwan.；Department of Medical Imaging, National Taiwan University Hospital, No. 7, Zhong-Shan S. Road, Taipei, 100, Taiwan; Institute of Medical Device and Imaging, National Taiwan University, No. 1, Sec. 1, Ren-Ai Road, Taipei, 100, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 106, Taiwan; Department of Biomedical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 106, Taiwan. Electronic address: wenchau@ntu.edu.tw.
期刊	Journal of the Formosan Medical Association = Taiwan yi zhi
SCI 分区	Q1
IF	2.6
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

背景： 长期以来，耳蜗导水管被认为是连接内耳与蛛网膜下腔的主要通道，但研究显示其在相当高比例的人群中存在阻塞。本研究旨在阐明蜗轴在淋巴液-脑脊液（CSF）沟通中的作用。
方法： 本单中心观察性研究前瞻性纳入一组诊断为单侧前庭神经鞘瘤（VS）的患者。在内耳专用磁共振图像上，定量评估延迟强化（静脉注射对比剂后4小时），并比较肿瘤、内听道（IAC）底和耳蜗蜗轴之间的强化，随后就肿瘤-蜗轴距离和内耳强化空间范围进行双变量相关和多变量回归分析。
结果： 共评估21例患者（平均年龄63.6±13.6岁，13名男性）。肿瘤和同侧内听道底液帽可见显著阳性强化（Wilcoxon符号秩检验，p<10-4），但对侧IAC未见显著强化（p=0.167）。与低级别强化组（n=11）相比，高级别强化空间范围组（n=10）的肿瘤-蜗轴距离更短（Mann-Whitney检验，p=0.004）。在控制肿瘤体积、年龄和性别后，有序logistic回归确定肿瘤-蜗轴距离是耳蜗强化等级的独立预测因子（每增加0.1 cm的校正比值比=0.366，p=0.001）。
结论： 我们证明了内耳强化呈肿瘤-蜗轴距离依赖性模式，这在定量上支持了蜗轴作为CSF-淋巴液沟通功能性门户的假说。

英文摘要

BACKGROUND: Long considered as the primary conduit to connect the inner ear and the subarachnoid space, the cochlear aqueduct has been shown obstructed in a paradoxically high percentage of population. This study aimed to elucidate the role of modiolus in perilymph-cerebrospinal fluid (CSF) communication.
METHODS: A cohort of patients diagnosed with unilateral vestibular schwannoma (VS) were prospectively enrolled in this single-center observational study. On inner ear-specific magnetic resonance images, delayed enhancement (4 h after intravenous contrast administration) was quantitatively evaluated and compared among the tumor, the fundus of the internal auditory canal (IAC), and the cochlear modiolus, followed by bivariate correlation and multivariable regression analyses with respect to tumor-modiolus distance and spatial extent of inner ear enhancement.
RESULTS: Twenty-one patients (mean age, 63.6 ± 13.6 years, 13 men) were evaluated. Significant positive enhancement was found in the tumor and the ipsilateral fundal fluid cap (Wilcoxon signed-rank test, p < 10-4), but not in the contralateral IAC (p = 0.167). The patient group with a high-grade spatial extent of enhancement (n = 10) had a shorter tumor-modiolus distance (Mann-Whitney test, p = 0.004), as compared with the low-grade group (n = 11). Ordinal logistic regression identified tumor-modiolus distance as an independent predictor of the cochlear enhancement grade (adjusted odds ratio = 0.366 per 0.1 cm increase, p = 0.001) after controlling for tumor volume, age, and sex.
CONCLUSION: We have demonstrated a tumor-modiolus-distance-dependent pattern of inner ear enhancement, quantitatively supporting the hypothesis that the modiolus serves as a functional gateway for CSF-perilymph communication.