Long TR three-dimensional inversion recovery sequence with real reconstruction(3D real IR)for quantifying inner ear endolymphatic hydrops

基于超长TR三维真实重建反转恢复序列(3D real IR)定量内耳内淋巴积水

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 3D real IR was helpful to quantifying inner ear EH.

目的观察超长TR三维真实重建反转恢复序列(3D real IR)定量内耳内淋巴积水(EH)的价值。方法前瞻性纳入46例梅尼埃病(MD)患者及21名健康志愿者,于注射对比剂后4~6 h行内耳MR 3D real IR和三维液体衰减反转恢复(3D FLAIR)序列扫描;对图像质量进行主观评分及不同序列间比较。测量耳蜗、前庭内淋巴间隙面积和膜迷路面积,计算内淋巴/膜迷路面积比,评估有无内耳EH及其程度。以MD患者确诊EH内耳为EH组、健康人内耳为对照组,比较组间耳蜗及前庭内淋巴面积、膜迷路面积及内淋巴/膜迷路面积比,绘制受试者工作特征(ROC)曲线,评估其诊断内耳EH效能。结果MD患者中56耳存在耳蜗和/或前庭EH,包括耳蜗EH 52耳、前庭EH 45耳(EH组)。对照组42耳未见EH。3D real IR图像质量主观评分高于3D FLAIR(P均<0.05)。3D real IR定量分析显示,EH组前庭及耳蜗内淋巴面积、内淋巴/膜迷路面积比均高于对照组(P均<0.001)。耳蜗、前庭内淋巴/膜迷路面积比鉴别EH耳与健耳的曲线下面积(AUC)分别为0.999、0.985,分别以13.64%、24.13%为截断值,其特异度分别为100%、92.86%,敏感度分别为96.43%、96.43%。结论MR超长TR 3D real IR有助于定量评估内耳EH。