MRI造影所见耳蜗积水与梅尼埃病分级的相关性研究

The correlation analysis of the cochlear hydrops degree found by MRI angiography with Meiniere′s disease classification

目的:探讨梅尼埃病(MD)患者耳蜗内淋巴积水程度与纯音听阈及疾病分级的相关性。方法:以31例单侧MD患者为研究对象,患侧鼓室内注入8倍稀释的钆喷酸葡胺注射液,24h后行内耳3DFLAIR序列磁共振成像(MRI),评估耳蜗内淋巴积水程度,并与临床疾病分级、纯音听阈进行相关性分析。结果:MRI显示31例患者耳蜗外淋巴间隙均见高信号显影,可清晰区分低信号的耳蜗内淋巴间隙。耳蜗积水程度0级4例,1级6例,2级11例,3级10例。31例患耳平均听阈为(54.37±3.88)dB HL。耳蜗内淋巴积水程度与纯音听阈(r=0.636,P<0.01)、临床疾病分级(r=0.516,P<0.01)有显著相关性。31例患者鼓室注入钆噪音剂后,均未诉不适,无鼓膜穿孔、感染等并发症。结论:MRI造影所见耳蜗内淋巴积水程度与疾病分级和纯音听阈显著相关,该检查方法可为MD诊断提供客观依据。

Objective ：To investigate the correlation between the levels of cochlear hydrops with the clinic clas- sification of Meniere＇s disease（MD）. Method：3D-F1AIR MRI was performed 24 hours after intratympanic injection of 8-fold diluted Gadopentetate Dimeglumine in 31 patients with unilateral MD. We evaluated the levels of cochlear hydrops and further analyzed the correlation between the levels of cochlear hydrops and thresholds of pure tone au- diometry and clinic classification of MD. Result.. MRI image clearly distinguished perilymph from endolymph in the labyrinth. The images showed different levels of enhancement of perilymphatic fluid spaces. In the 31 patients, obvious signs of endolymphatic hydrops were found, including 4 cases of level 0, 6 cases of level 1, 11 cases of level 2 and 10 cases of level 3. Their average hearing threshold was（54.37±3.88）dB HL. The levels of cochlear hydrops were significantly correlated with pure tone audiometry thresholds （r= 0. 636,P〈0.01） and MD classifi- cation（r= 0. 516, P〈0. 01）. None of the patients after intratympanic injection complained about discomfort or happened with any complications such as eardrum perforation, infection, and so on. Conclusion：The degree of en- dolymphatic hydrops based on MRI in MD patient has significant correlation with the pure tone audiometry and classification of disease. The examination can act as an objective index for MD diagnosis.