Gadolinium-enhanced MRI reveals dynamic development of endolymphatic hydrops in Ménière's disease.
Gadolinium-enhanced MRI reveals dynamic development of endolymphatic hydrops in Ménière's disease.
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钆增强 MRI 揭示梅尼埃病内淋巴积水的动态发展
DOI：
10.1016/j.bjorl.2018.10.014
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发表时间：
2020-03
影响因子：
2.2
通讯作者：
Zhang, Ru
中科院分区：
文献类型：
--
作者：
Li, Xuanyi;Wu, Qianru;Sha, Yan;Dai, Chunfu;Zhang, Ru
梅尼埃氏病与听力受损、耳鸣、眩晕和听觉充盈有关。许多解剖学研究表明特发性内淋巴积液是梅尼埃病的病理基础，现在可以通过内耳钆增强磁共振成像来观察。目的：通过对梅尼埃病患者前庭和耳蜗的监测，探讨梅尼埃病患者内淋巴积液的发生情况。对178例确诊为单侧梅尼埃病的患者进行双侧鼓室内注射钆后的三维液体衰减反转恢复和三维真实反转恢复磁共振成像。扫描用于评估前庭和耳蜗结构（包括耳蜗尖转、耳蜗中转和耳蜗基底转）内淋巴水肿的存在和程度。确定了内耳各部位发生内淋巴积液的相关性。所有患者均在患侧检测到症状性内淋巴积液，而32例（18.0%）患者在未受影响的对侧检测到无症状性内淋巴积液。患侧耳蜗尖部和中部的内淋巴积液发生率明显高于基底部和前庭。从耳蜗尖转到耳蜗基底转，内淋巴积液的严重程度逐渐降低。对侧耳蜗无症状内淋巴积液的发生率和程度均显著高于前庭（p < 0.05），两耳蜗间无显著差异。内淋巴积液的进展似乎是有方向性的，起源于耳蜗。内淋巴积液的严重程度从耳蜗尖转到耳蜗基底转再到前庭依次递减。前庭内淋巴积液与症状性梅尼埃病有关。
Meniere's disease is associated with impaired hearing, tinnitus, vertigo, and aural fullness. Many anatomical studies have suggested idiopathic endolymphatic hydrops as the pathological basis of Meniere's disease, which now can be visualized by using gadolinium -enhanced magnetic resonance imaging of the inner ear. To investigate the development of endolymphatic hydrops in Meniere's disease by monitoring the vestibules and cochleae of affected patients. Inner ears of 178 patients with definite unilateral Meniere's disease diagnosis were visualized by 3-dimensional fluid-attenuated inversion recovery and three-dimensional real inversion recovery magnetic resonance imaging following bilateral gadolinium intratympanic injection. The scans were used to evaluate the presence and degree of endolymphatic hydrops in the vestibules and cochlear structures, including the cochlear apical turn, the cochlear middle turn, and the cochlear basal turn. The correlation of endolymphatic hydrops occurrence between the various parts of the inner ear was determined. Symptomatic endolymphatic hydrops was detected on the affected side in all patients, whereas asymptomatic endolymphatic hydrops was detected on the unaffected contra-lateral side in 32 patients (18.0%). On the affected side, the cochlear apical turn and the cochlear middle turn demonstrated significantly higher rates of endolymphatic hydrops than the cochlear basal turn and the vestibule. The severity of endolymphatic hydrops gradually decreased from the cochlear apical turn to the cochlear basal turn. On the contra lateral side, the incidence and degree of the detected asymptomatic endolymphatic hydrops were significantly greater in the cochleae than in the vestibules (p < 0.05), with no significant difference detected between the cochlear turns. Progression of endolymphatic hydrops appears to be directional, initiated in the cochlea. The order of endolymphatic hydrops severity gradually decreases from the cochlear apical turn to the cochlear basal turn and then to the vestibule. Endolymphatic hydrops in the vestibule is associated with symptomatic Meniere's disease.
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影响因子：
1.4
作者：
Valk, W. L.;Wit, H. P.;Albers, F. W. J.
通讯作者：
Albers, F. W. J.
影响因子：
2.6
作者：
Moller, Martin Nue;Kirkeby, Svend;Caye-Thomasen, Per
通讯作者：
Caye-Thomasen, Per
影响因子：
1.4
作者：
OKUNO, T;SANDO, I
通讯作者：
SANDO, I
影响因子：
2.8
作者：
Egami, Naoya;Kakigi, Akinobu;Yamasoba, Tatsuya
通讯作者：
Yamasoba, Tatsuya
影响因子：
2.1
作者：
Merchant, SN;Adams, JC;Nadol, JB
通讯作者：
Nadol, JB