Semi-quantitative evaluation of endolymphatic hydrops by bilateral intratympanic gadolinium-based contrast agent (GBCA) administration with MRI for Meniere's disease
Semi-quantitative evaluation of endolymphatic hydrops by bilateral intratympanic gadolinium-based contrast agent (GBCA) administration with MRI for Meniere's disease
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DOI：
10.3109/00016480902858881
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发表时间：
2010-01-01
影响因子：
1.4
通讯作者：
Usami, Shin-Ichi
中科院分区：
文献类型：
--
作者：
Fukuoka, Hisakuni;Tsukada, Keita;Usami, Shin-Ichi
结论：在MRI中成功地进行了双侧鼓室内给予钆基造影剂（GBCA），并被证明有利于内淋巴积水的半定量评价。这种基于图像的诊断将导致梅尼埃病（MD）的诊断标准的重新评估和重新分类。目的：通过双侧鼓室内注射GBCA，MRI半定量显示MD患者的内淋巴积水。患者和方法：共13例患者进行了评估，其中12例MD和1例急性低音调感音神经性听力损失。通过鼓膜向双侧鼓室注射稀释的钆双胺（一种GBCA）。24 h后用3.0 T MR扫描仪对内淋巴积水进行评估。半定量测量钆双胺增强的面积。结果如下：三维液体衰减反转恢复（3D-FLAIR）MRI显示，钆双胺成功穿透圆窗膜，进入外淋巴间隙，并描绘出钆双胺增强的内耳外淋巴间隙和钆双胺阴性的内耳内淋巴间隙。所有MD患者均表现为代表外淋巴间隙的钆双胺增强区缩小，定量比值为0.15 ~ 0.85。此外，内淋巴积水也表现在不典型的MD患者波动性低频感音神经性听力损失无眩晕。
Conclusion: Bilateral intratympanic administration of a gadolinium-based contrast agent (GBCA) in MRI was successfully performed and proved to be beneficial in the semi-quantitative evaluation of endolymphatic hydrops. Such image-based diagnosis will lead to re-revaluation and reclassification of the diagnostic criteria for Meniere's disease (MD). Objective: To visualize endolymphatic hydrops semi-quantitatively in patients with MD, by using bilateral intratympanic GBCA administration with MRI. Patients and methods: A total of 13 patients were evaluated, including 12 with MD and one with acute low-tone sensorineural hearing loss. Diluted gadodiamide (a kind of GBCA) was administered to the bilateral tympanic cavity by injection through the tympanic membrane. After 24 h, the endolymphatic hydrops was evaluated with a 3.0 T MR scanner. The areas enhanced by gadodiamide were measured semi-quantitatively. Results: Three-dimensional, fluid-attenuated inversion recovery (3D-FLAIR) MRI showed that the gadodiamide successfully penetrated the round window membrane, entering the perilymphatic space and delineating the gadodiamide-enhanced perilymphatic and gadodiamide-negative endolymphatic spaces of the inner ear. All the patients with MD showed a reduced gadodiamide-enhanced area representing the perilymphatic space, and the quantitative ratio was 0.15 to 0.85. Furthermore, endolymphatic hydrops was also demonstrated in the patient with atypical MD who had fluctuating low frequency sensorineural hearing loss without vertigo.