内耳内淋巴积液MR诊断中的测量差异及方法回顾

Comparison of endolymphatic hydrops measurement methods in Meniere 's Disease

目的探讨两种MR扫描增强扫描方法在梅尼埃患者内淋巴积液中的作用价值及差异。方法 31例单侧型梅尼埃患者,每位患者均提前24 h接受双耳稀释8倍的钆对比剂(马根维显)鼓室注药后行MRI,对3D-real IR、3DFLAIR两种序列所显示的外半规管环完全显露的前庭最下方层面及后半规管部分显影的前庭层面内淋巴积液的程度进行评价和显示,并回顾了目前国内外显示内淋巴积液的扫描技术及测量方法。结果选取外半规管环完全显露的前庭最下方层面在两种序列(3D-real IR,3D-flair)并测量内淋巴积液程度,两组内淋巴间隙百分比分别为(39.48±18.35)%和(29.30±17.17)%,差异有统计学意义(P=0.004),经MPR处理后显示后半规管部分显影的层面,3D-real IR序列和3DFLAIR序列所测得的前庭区内淋巴液占总淋巴液范围比例分别为(48.29±10.03)%和(40.18±13.87)%,差异有统计学意义(P=0.002)。3D-real IR序列获得图像中分别选取外半规管环完全显露的前庭最下方层面及和后半规管部分显影的前庭层面,两者所测得内淋巴积液程度有统计学差异(P=0.004)。3D-FLAIR序列中选取外半规管环完全显露的前庭最下方层面进行测量和后半规管部分显影的层面,两者所测得内淋巴积液程度也存在统计学差异(P<0.05),在中重度内淋巴积液的患者中更为明显。结论 3D-real IR和3D-FLAIR两种序列对不同层面测量前庭内淋巴积液范围的评估存在差异,在中重度内淋巴积水患者中差异更明显。

Objective To compare the endolymphatic hydrops measurement methods in Meniere’s Disease (MD). Methods Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and 3D real inversion recovery (IR) MRI was performed on 31 patients with unilateral MD at 24 hours after bilateral intratympanic injection of gadolinium. The ratios of endolymph fluid to the total fluid-filled areas were measured in the inferior slice of vestibule where the lateral semicircular canal was visible and in the slice at the level of the posterior semicircular canal. Results The percentage of endolymphatic hydrops at the vestibule level was significantly higher (P=0.004, 0.002) on IR-(39.48±18.35%, 48.29±10.03%) than that on FLAIR-(29.30±17.17%, 40.18±13.87%) weighted sequences at both the levels of vestibule and posterior semicircular canal, respectively. Significant difference was also found in the measurements of endolymphatic hydrops between the two slice positions on both IR (P=0.004) and FLAIR (P<0.05) imaging. Conclusion Measurements of endolymphatic hydrops vary with MRI slice position and pulse sequences.