Volume quantification of endolymphatic hydrops in patients with vestibular schwannoma.
Volume quantification of endolymphatic hydrops in patients with vestibular schwannoma.
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前庭神经鞘瘤患者内淋巴积水的体积定量
DOI：
10.1016/j.nicl.2021.102656
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Yin S
中科院分区：
文献类型：
--
作者：
Wang J;Li C;Liu Y;Tian Y;Xiong Y;Feng Y;Yu D;Chen Z;Yin S
VS患者前庭症状的起源尚不清楚。鼓室内钆增强MRI可证实迷迷路病变。对前庭EH的评估，内淋巴间隙体积百分比比面积百分比更准确。VS患者的前庭症状可能起源于周围病变。前庭神经鞘瘤（VS）患者前庭症状的起源尚不清楚。我们使用鼓室内钆增强磁共振成像（MRI）确认VS患者迷路病变，并探讨这些患者的内淋巴水肿（EH）特征。本研究共纳入66例诊断为单侧VS的患者，并接受鼓室内钆增强MRI检查。在轴向MRI图像上绘制前庭和内淋巴的边界，利用Osirix软件自动计算前庭和内淋巴的面积和体积，得到前庭内淋巴的面积和体积百分比。患侧前庭内淋巴面积和体积百分比均显著大于健康侧（p < 0.001）。通过Kendall's W检验，我们发现患侧前庭内淋巴面积和体积百分比是一致的（p < 0.001），但一致性是中等的（k = 0.574）。健康侧也一致（p < 0.001），一致程度为中等（k = 0.444）。我们使用19.1%作为分界点来区分前庭EH的存在与否；也就是说，前庭内淋巴体积百分比大于19.1%被定义为有积液的亚组，而无积液的亚组包括基线水平低于19.1%的患者。没有提出前庭EH的体积分类。根据这一标准，本研究中11/66（16.7%）的VS患者有前庭EH。结论。前庭内淋巴体积百分比比面积百分比更准确地评估前庭EH。以19.1%作为区分前庭EH存在与否的截断点，我们发现16.7%的VS患者存在不同程度的前庭EH。我们认为VS患者的前庭症状可能起源于周围病变。
Origin of vestibular symptoms in patients with VS is unknown. Intratympanic gadolinium-enhanced MRI could confirm labyrinthine lesion in VS. The volume percentage of the endolymphatic space was more accurate than the area percentage for assessing vestibular EH. Vestibular symptoms in patients with VS may originate from peripheral lesions. The origin of vestibular symptoms in patients with vestibular schwannoma (VS) is uncertain. We used intratympanic gadolinium-enhanced magnetic resonance imaging (MRI) to confirm the labyrinthine lesions in patients with VS and to explore the features of endolymphatic hydrops (EH) in these patients. In total, 66 patients diagnosed with unilateral VS were enrolled in this study and underwent intratympanic gadolinium-enhanced MRI. The borders of the vestibule and endolymph were mapped on the axial MRI images, and the area and volume of vestibule and endolymph were automatically calculated using Osirix software, and the area and volume percentage of vestibular endolymph were obtained. The area and volume percentages of vestibular endolymph on the affected side were significantly larger than those on the healthy side (both p < 0.001). Using Kendall's W test, we found that the area and volume percentages of vestibular endolymph on the affected side were consistent (p < 0.001), but the consistency was moderate (k = 0.574). The healthy side was also consistent (p < 0.001), and the degree of consistency was moderate (k = 0.444). We used 19.1% as the cut-off point to distinguish the presence or absence of vestibular EH; that is, the volume percentage of vestibular endolymph that was more than 19.1% were defined as the subgroup with hydrops, while the subgroup without hydrops included patients with a baseline level below 19.1%. No volume classification for vestibular EH was proposed. Based on this standard, 11/66 (16.7%) of the patients with VS in this study had vestibular EH. Conclusions. The volume percentage of the vestibular endolymph was more accurate than the area percentage for assessing vestibular EH. Using 19.1% as the cut-off point to distinguish the presence or absence of vestibular EH, we found that 16.7% of patients with VS had varying degrees of vestibular EH. We believe that the vestibular symptoms in patients with VS may originate from the peripheral lesions.
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