目的分析单侧梅尼埃病(Ménière s disease,MD)患者常规磁共振成像(MRI)内淋巴囊与前庭水管(vestibular aqueduct,VA)的影像指征,探讨MD患者解剖因素的影像学特征。方法纳入单侧MD患者(MD组)和健康者(对照组)各80例进行三维可...目的分析单侧梅尼埃病(Ménière s disease,MD)患者常规磁共振成像(MRI)内淋巴囊与前庭水管(vestibular aqueduct,VA)的影像指征,探讨MD患者解剖因素的影像学特征。方法纳入单侧MD患者(MD组)和健康者(对照组)各80例进行三维可变翻转角快速自旋回波序列(3-dimensional sampling perfection with application optimized contrast using different flip angle evolutions,3D-SPACE)MRI,测量后半规管(posterior semicircular canal)垂直部至后颅窝(posterior fossa)距离(以“MRI-PP距离”表示),间接表示岩骨内淋巴囊大小,分析其与MRI影像中前庭水管(vestibular aqueduct,VA)可视性(MRI-VA可视性)之间的相关性。结果①MD组患侧与健侧相比,MRI-PP距离(Z=-0.135,P=0.893)和MRI-VA可视性均无显著性差异(P=0.344);对照组耳间MRI-PP距离(t=-0.403,P=0.688)和MRI-VA可视性亦无显著性差异(P=0.302);②对于MRI-PP距离而言,MD组患侧[1.61(1.03,2.63)mm]及健侧[1.73(0.97,2.49)mm]均小于对照组右侧[2.20(1.79,3.19)mm]及左侧(2.49±1.26 mm);③对于MRI-VA可视性而言,MD组患侧(16.25%)及健侧(21.25%)均与对照组右侧(36.25%)及左侧(30%)无统计学差异。④合并分析两组数据,或单独分析MD组或对照组,均未发现MRI-PP距离对MRI-VA可视性的影响有统计学意义(均为P>0.05)。结论单侧MD患者3D-SPACE序列MRI中PP距离与VA的可视性不具有相关性,提示这两个参数可独立应用于临床研究。展开更多
This study looked into the efficacy of a modified titration protocol of intratympanic gentamicin injection（ITG） in the patients with unilateral intractable Ménière＇s disease（MD）. Modified titration prot...This study looked into the efficacy of a modified titration protocol of intratympanic gentamicin injection（ITG） in the patients with unilateral intractable Ménière＇s disease（MD）. Modified titration protocol of ITG at a low dose（20 mg/m L） was administered to 10 patients with definite unilateral intractable MD. After initial first two fixed ITGs on weekly basis,the patients might or might not be given any more injections,depending on the appearance of unilateral vestibular loss（UVL）. ITG was terminated if the patients satisfied the criteria of UVL. All patients were followed-up for at least two years. The effects of ITG on the vertigo attack,functional level scores and postural balance were evaluated. Of the 10 cases,8 showed the sign of UVL after receiving initial two ITGs and were not given any more intratympanic injections,and the other 2 patients were administered three ITGs. A two-year follow-up revealed that complete and substantial vertigo control was achieved in 9 cases,and limited vertigo control in 1 patient. Hearing level was lowered in 2 patients. The posture stability and functional level scores were improved. Our study showed that the modified titration protocol of ITG at a low dose could effectively control vertigo in patients with unilateral intractable MD.展开更多
文摘目的分析单侧梅尼埃病(Ménière s disease,MD)患者常规磁共振成像(MRI)内淋巴囊与前庭水管(vestibular aqueduct,VA)的影像指征,探讨MD患者解剖因素的影像学特征。方法纳入单侧MD患者(MD组)和健康者(对照组)各80例进行三维可变翻转角快速自旋回波序列(3-dimensional sampling perfection with application optimized contrast using different flip angle evolutions,3D-SPACE)MRI,测量后半规管(posterior semicircular canal)垂直部至后颅窝(posterior fossa)距离(以“MRI-PP距离”表示),间接表示岩骨内淋巴囊大小,分析其与MRI影像中前庭水管(vestibular aqueduct,VA)可视性(MRI-VA可视性)之间的相关性。结果①MD组患侧与健侧相比,MRI-PP距离(Z=-0.135,P=0.893)和MRI-VA可视性均无显著性差异(P=0.344);对照组耳间MRI-PP距离(t=-0.403,P=0.688)和MRI-VA可视性亦无显著性差异(P=0.302);②对于MRI-PP距离而言,MD组患侧[1.61(1.03,2.63)mm]及健侧[1.73(0.97,2.49)mm]均小于对照组右侧[2.20(1.79,3.19)mm]及左侧(2.49±1.26 mm);③对于MRI-VA可视性而言,MD组患侧(16.25%)及健侧(21.25%)均与对照组右侧(36.25%)及左侧(30%)无统计学差异。④合并分析两组数据,或单独分析MD组或对照组,均未发现MRI-PP距离对MRI-VA可视性的影响有统计学意义(均为P>0.05)。结论单侧MD患者3D-SPACE序列MRI中PP距离与VA的可视性不具有相关性,提示这两个参数可独立应用于临床研究。
基金supported by the National Science&Technology Pillar Program during the 12th Five-year Plan of China(No.2012BAI12B02)the 11th Five-year Plan of China(No.2007BAI18B13)National Natural Science Foundation of China(No.30872865)
文摘This study looked into the efficacy of a modified titration protocol of intratympanic gentamicin injection（ITG） in the patients with unilateral intractable Ménière＇s disease（MD）. Modified titration protocol of ITG at a low dose（20 mg/m L） was administered to 10 patients with definite unilateral intractable MD. After initial first two fixed ITGs on weekly basis,the patients might or might not be given any more injections,depending on the appearance of unilateral vestibular loss（UVL）. ITG was terminated if the patients satisfied the criteria of UVL. All patients were followed-up for at least two years. The effects of ITG on the vertigo attack,functional level scores and postural balance were evaluated. Of the 10 cases,8 showed the sign of UVL after receiving initial two ITGs and were not given any more intratympanic injections,and the other 2 patients were administered three ITGs. A two-year follow-up revealed that complete and substantial vertigo control was achieved in 9 cases,and limited vertigo control in 1 patient. Hearing level was lowered in 2 patients. The posture stability and functional level scores were improved. Our study showed that the modified titration protocol of ITG at a low dose could effectively control vertigo in patients with unilateral intractable MD.
