Magnetic Resonance Imaging of the Inner Ear in Meniere's Disease
Magnetic Resonance Imaging of the Inner Ear in Meniere's Disease
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DOI：
10.1016/j.otc.2010.06.001
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发表时间：
2010-10-01
影响因子：
1.7
通讯作者：
Naganawa, Shinji
中科院分区：
文献类型：
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作者：
Pyykko, Ilmari;Zou, Jing;Naganawa, Shinji
最近的磁共振成像（MRI）技术已经使得使用钆螯合物（GdC）作为对比剂检查耳蜗的隔室成为可能。由于GdC在健康内耳中不进入内淋巴而进入外淋巴间隙，因此该技术为观察不同耳蜗隔室和评估内耳屏障的完整性提供了可能性。本文综述了内耳MRI技术、对比剂应用和相关耳毒性研究的最新进展，并且GdC在内耳中的摄取动力学GdC引起中耳粘膜的炎症，但没有任何报告或证据表明有毒性在动物或人体内的相关变化在给药后约10分钟，静脉内给予的GdC到达豚鼠耳蜗，并加载鼓阶和鳞片前庭，60分钟达到高峰。然而，静脉注射GdC后，小鼠的外淋巴负荷峰值为80至100分钟。在健康动物中，中阶不加载GdC。在圆窗上局部给予GdC的小鼠中，耳蜗负荷在4小时达到峰值，此时达到顶点。在具有内淋巴积水（EH）的动物模型中，观察到Reissner膜的隆起作为前庭阶中GdC的缺陷。组织学上，膨出程度与MR图像相关。在具有免疫反应诱导的EH的动物中，MRI显示EH可以局限于内耳的受限区域，并且在同一内耳中，EH和GdC泄漏到中阶中都是可见的。GdC的加载遵循在动物中观察到的模式，但时间范围不同。在静脉内递送双倍剂量GdC时，内耳隔室在4小时后可见。局部递送后2小时至7小时之间人外淋巴中GdC的摄取模式需要澄清。在几乎所有可能或怀疑梅尼埃病的患者中，EH得到证实。推荐使用流体衰减反转恢复序列的12极线圈的特定算法用于人体初始成像
Recent magnetic resonance imaging (MRI) techniques have made it possible to examine the compartments of the cochlea using gadolidium-chelate (GdC) as a contrast agent. As GdC loads into the perilymph space without entering the endolymph in healthy inner ears, the technique provides possibilities to visualize the different cochlear compartments and evaluate the integrity of the inner ear barriers This critical review presents the recent advancements in the inner ear MRI technology, contrast agent application and the correlated ototoxicity study, and the uptake dynamics of GdC in the inner ear GdC causes inflammation of the mucosa of the middle ear, but there are no reports or evidence of toxicity-related changes in vivo either in animals or in humans Intravenously administered GdC reached the guinea pig cochlea about 10 minutes after administration and loaded the scala tympani and scale vestibuli with the peak at 60 minutes. However, the perilymphatic loading peak was 80 to 100 minutes in mice after intravenous administration of GdC. In healthy animals the scala media did not load GdC. In mice in which GdC was administered topically onto the round window, loading of the cochlea peaked at 4 hours, at which time it reached the apex. The initial portions of the organ to be filled were the basal turn of the cochlea and vestibule In animal models with endolymphatic hydrops (EH), bulging of the Reissner's membrane was observed as deficit of GdC in the scala vestibuli. Histologically the degree of bulging correlated with the MR images. In animals with immune reaction-induced EH, MRI showed that EH could be limited to restricted regions of the inner ear, and in the same inner ear both EH and leakage of GdC into the scala media were visualized More than 100 inner ear MRI scans have been performed to date in humans. Loading of GdC followed the pattern seen in animals, but the time frame was different. In intravenous delivery of double-dose GdC, the inner ear compartments were visualized after 4 hours The uptake pattern of GdC in the perilymph of humans between 2 hours and 7 hours after local delivery needs to be clarified. In almost all patients with probable or suspected Meniere's disease, EH was verified. Specific algorithms with a 12-pole coil using fluid attenuation inversion recovery sequences are recommended for initial imaging in humans