Objective To observe the value of long TR three-dimensional inversion recovery sequence with real reconstruction(3D real IR)for quantifying inner ear endolymphatic hydrops(EH).Methods Totally 46 Ménière's disease(MD)patients and 21 healthy volunteers were prospectively enrolled.MR scanning for inner ear based on 3D real IR and 3D fluid attenuated inversion recovery(3D FLAIR)sequence 4—6 h after administration of contrast agents were performed.The imaging qualities were scored and compared between groups.The endolymphatic space area and the membranous labyrinth area of cochlea and vestibule,as well as endolymph/membranous labyrinth area percentage were calculated,the present or not of EH and the grade of EH were evaluated.EH inner ears of MD patients were enrolled in EH group,while inner ears of healthy volunteers were taken as controls(control group).The endolymphatic space area,membranous labyrinth area and endolymph/membranous labyrinth area percentage of cochlea and vestibule were compared between groups.The receiver operating characteristic(ROC)curve was drawn to calculate the diagnostic efficacy of the above indexes.Results Cochlear and/or vestibular EH were detected in 56 ears,including cochlear EH in 52 ears and vestibular EH in 45 ears among 46 MD patients(EH group),but not in 42 ears in control group.The subjective quality scores of 3D real IR images were higher than those of 3D-FLAIR(both P<0.05).Quantitative analysis based on 3D real IR images revealed that,compared with control group,significantly larger endolymph areas and endolymph/membranous labyrinth area percentages in both cochlea and vestibule were found in EH group(all P<0.001).The area under the curve(AUC)of cochlear or vestibular endolymph/membranous labyrinth area percentage for identifying inner ear EH was 0.999 and 0.985,respectively.Taken 13.64%and 24.13%as the critical value of cochlear or vestibular endolymph,the specificity was 100%and 92.86%,respectively,and the sensitivity was 96.43%and 96.43%,respectively.Conclusion MR long TR
目的探讨梅尼埃病(meniere's disease,MD)患者内淋巴积水(endolymphatic hydrops,EH)程度与临床特征的相关性。方法研究对象为2020年12月—2022年3月就诊北京清华长庚医院的31例MD患者,所有患者均行纯音测听(pure tone audiometry,PTA)、耳蜗电图(electrocochleogram,ECochG)、耳鸣分级、眩晕残障程度评定量表(dizziness handicap inventory,DHI)评分及内耳钆造影MRI扫描。据内耳MRI显像,采用目测4分法,以3D FLAIR序列评估前庭积水程度,以3D real IR序列评估耳蜗积水程度,采用Spearman秩相关检验和Fisher精确检验分析EH程度与患者临床特征的相关性。结果不同EH程度患者的性别、年龄、侧别及病程比较,差异无统计学意义(P>0.05);Spearman相关性分析显示,耳蜗积水程度与耳鸣分级、低频听阈、平均听阈及疾病分期呈正相关(r_(s)=0.517、0.438、0.439、0.378,P<0.05),与ECochG无明显相关性(P>0.05);前庭积水程度与发作频率呈正相关(r_(s)=0.361,P<0.05),与DHI及其躯体、情绪、功能方面评分无明显相关性(P>0.05)。结论应用内耳钆造影不同MRI序列评估EH程度发现与MD患者听力、疾病分期、眩晕发作频率及耳鸣分级有相关性,可用于临床诊断MD、评估患者EH程度。
