梅尼埃病的内淋巴积水和积水程度在3D CUBE FLAIR MRI中的显影分析

The Development Analysis of Detecting and Grading of Endolymphatic Hydrops in Meniere’s Disease with 3D CUBE FLAIR MRI

目的通过静脉注射钆喷酸葡胺对比剂,行内耳三维快速液体衰减反转恢复序列磁共振成像(3D CUBE FLAIR MRI),探讨梅尼埃病(MD)膜迷路积水在前庭和耳蜗显像的阳性率,评价内耳3D CUBE FLAIR MRI在MD诊断中的可靠性和有效性。方法搜集确诊为单侧MD的48例患者,经静脉注射2支钆对比剂,6 h后在3.0 T场强下行内耳3D CUBE FLAIR MRI扫描,观察内、外淋巴间隙的显影情况,利用球囊面积与椭圆囊面积的比率(SURI)技术对前庭积水进行分级,利用半定量分级方法对耳蜗积水进行分级,分析并评估内淋巴积水(EH)的程度。结果应用3D CUBE FLAIR MRI的48例患者中患侧及健侧前庭和耳蜗内、外淋巴间隙均清晰显影,显示率为100%(48/48),可成功对比显示患侧前庭及耳蜗EH的情况,其中前庭轻度积水3例,中度积水15例,重度积水30例,达到MD诊断标准的中度及重度积水患者共45例,诊断准确率为93.8%(45/48);9例(18.8%)可清晰显示耳蜗积水。结论经静脉内耳钆造影的3D CUBE FLAIR MRI检查MD患者膜迷路积水具有较高的阳性率,并且可以对其积水程度进行分级,可为MD的诊断提供直接的影像学参考依据。

Objective evaluate the reliability and validity of Meniere’s disease as shown by three-dimensional cube fluid-attenuated inversion recovery magnetic resonance imaging(3 D CUBE FLAIR MRI) performed six hours after intravenous gadolinium(Gd) injection and discuss the positive rate of endolymphatic hydrops in the vestibule and cochlea. Methods A total of 48 patients diagnosed with unilateral MD were collected. Two gadolinium contrast agents were injected intravenously. After 6 hours, the inner ear 3 D CUBE FLAIR MRI scan was performed at a field strength of 3.0 T to observe the development of the inner and outer lymphatic spaces.Concerning vestibule hydrops, we graded it using the SURI.For the cochlea hydrops, we used the semi-quantitativemethods. We observed the endolyphatic and perilymphatic space and then assessing the extent of endolymphatic hydrops in the MR images. Results With 3 D CUBE FLAIR MRI,we can clearly show that the endolyphatic and perilymphatic space of the affected side and normal side in 48 cases with a display rate of 100.0%(48/48).It successfully demonstrated the vestibule and cochlea hydrops.Among them, there were three cases of mild,15 cases of moderate and thirty cases of severe vestibule hydrops. The moderate and severe vestibule hydrops which reached the diagnostic criteria of Meniere’s disease in 45 cases with a diagnostic rate of 93.8%(45/48),and the cochlea hydrops in 9 cases with a diagnostic rate of 18.8%(9/48). Conclusion 3 D CUBE FLAIR MRI has a high positive diagnostic rate in grading and assessing endolymphatic hydrops of Meniere’s disease and provides direct imaging evidence for diagnosing MD.