Progression of Endolymphatic Hydrops in Meniere's Disease as Evaluated by Magnetic Resonance Imaging
Progression of Endolymphatic Hydrops in Meniere's Disease as Evaluated by Magnetic Resonance Imaging
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DOI：
10.1097/mao.0b013e31822a1ce2
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发表时间：
2011-09-01
影响因子：
2.1
通讯作者：
Barbieri, Franco
中科院分区：
文献类型：
--
作者：
Fiorino, Francesco;Pizzini, Francesca B.;Barbieri, Franco
目的：评价单侧梅尼埃病（MD）患者鼓室内注射钆后，作为疾病持续时间的函数的内淋巴积水（EH）的存在和程度，在3特斯拉磁共振成像装置中使用三维液体衰减反转恢复序列进行估计。患者：共有32例患者（21例男性和11例女性受试者，年龄25-78岁;中位数56岁）参加了研究。病程2个月~ 10年（中位数，3年），在过去6个月内眩晕发作的患病率范围为每月0.5至8次干预：0.6 ml钆布醇溶液（1 mmol/ml）稀释1：使用22号脊椎针，通过鼓膜的后象限将7的盐水溶液注射到患耳中。每次注射后，将患者头部对侧旋转45度30分钟。24小时后，三维流体衰减反转恢复磁共振imaging performed.Main Outcome Measure：Perilymphatic enhancement was evaluated in the different portions of the labyrinth as a function of MD duration.Results：前庭增强的减少或不存在发生早熟，并发生在所有受试者在长期。耳蜗和半规管增强异常的患病率与MD持续时间成正比。远期前庭和耳蜗积水较半规管严重。增强异常和MD持续时间之间的统计学显着相关性观察大多数内耳sites.Conclusion：EH的患病率和严重程度的增加与MD的持续时间表明，水肿是一个渐进的退行性现象。前庭和其次是耳蜗的频繁异常与一些组织病理学检查结果一致。水肿变化是否与MD的特定体征和症状相关仍有待澄清。
Objective: To evaluate the presence and the degree of endolymphatic hydrops (EHs) in patients with unilateral Meniere's disease (MD), as a function of duration of the disease, estimated using a 3-dimensional fluid-attenuated inversion recovery sequence in a 3-Tesla magnetic resonance imaging unit, after intratympanic gadolinium administration.Patients: A total of 32 patients (21 male and 11 female subjects, aged 25-78 yr; median, 56 yr) participated in the investigation. The duration of the disease ranged from 2 months to 10 years (median, 3 yr), with a prevalence of vertigo spells in the last 6 months ranging from 0.5 to 8 per month (median, 2.5).Intervention: A 0.6-ml solution of gadobutrol (1 mmol/ml) diluted 1: 7 in saline was injected in the affected ear through the inferior-posterior quadrant of the tympanic membrane, using a 22-gauge spinal needle. The patient was kept with the head rotated 45 degrees contralaterally for 30 minutes after each injection. Twenty-four hours later, a 3-dimensional fluid-attenuated inversion recovery magnetic resonance imaging was performed.Main Outcome Measure: Perilymphatic enhancement was evaluated in different portions of the labyrinth as a function of MD duration.Results: Reduced or absence of enhancement of the vestibule occurred precociously and occurred in all subjects at long term. The prevalence of enhancement abnormalities in the cochlea and the semicircular canals was directly proportional to MD duration. At long term, the vestibule and the cochlea showed a more severe hydropic involvement compared with semicircular canals. A statistical significant correlation between enhancement abnormalities and MD duration was observed for most inner ear sites.Conclusion: The increased prevalence and severity of EH with the duration of MD indicates that hydrops is a progressive degenerative phenomenon. The frequent abnormality in the vestibule and, secondarily, in the cochlea is in line with some histopathologic investigations. It remains to be clarified whether hydropic changes are related to specific signs and symptoms of MD.