梅尼埃病内淋巴积水MRI影像诊断评价及影响因素分析  

Factors affecting 3T MRI in Detecting Endolymphatic Hydrops in Meniere's Disease

作　　者：杨凤[1,2] 刘阳 王庆军 赵丹珩 赵鹏举 孙建军 宋任东[1] 

机构地区：[1]保定市第二中心医院耳鼻喉科,涿州072750 [2]海军总医院全军耳鼻喉科中心,北京100048 [3]海军总医院放射影像科,北京100048

出　　处：《中华耳科学杂志》2015年第3期493-496,共4页Chinese Journal of Otology

摘　　要：目的针对拟诊为梅尼埃病的患者,以MRI检测内淋巴积水为方法,探讨在梅尼埃病诊断中以此方法确诊为内淋巴积水的可行性,并评估临床诊断价值,分析影响判定结果的相关因素。方法选择2013.6月-2014.11月间住院病人梅尼埃病43例做为研究对象,经鼓室注射钆喷酸葡胺造影剂24小时后进行内耳MRI检查,MRI扫描序列为T1加权三维自旋回波序列(3D-FSE-T1WI),所得图像以前庭和耳蜗底转各自内淋巴面积占内外淋巴面积之和的比率大于1/3为阳性,应用三分法进行定性判定,进行计数并统计。结果在43例梅尼埃病中,35例(81.40%)在前庭发现内淋巴积水,4例(9.30%)未发现积水,另外4例(9.30%)不能确定;在耳蜗,36例(83.72%)发现内淋巴积水,3例(6.98%)未发现积水,另外4例(9.30%)不能确定。结论鼓室内注射顺磁性造影剂后内耳MRI检查可发现内淋巴积水,是临床确定内淋巴积水有效和可行的方法。其主要影响因素包括造影剂进入内耳受阻扩散不良、鼓室给药技术、MRI检测技术及主观判定因素。Objective The aim of this study was to discuss feasibility and reliability of 3T MRI in detecting endolymphatic hydrops （EH） in Meniere＇ s disease （MD）. Another aim was to assess factors that might affect study results. Methods Forty-three patients with unilateral clinically confirmed MD were evaluated with inner ear MRI. MRI imaging was completed 24 h after intratympanic administration of gadolinium chelate. The sequence of MRI was three-dimensional fast spin-echo Tl-weighted imaging （3D-FSE-T1WI）. A 3-point scoring system was used in the assessment of EH. Positive results were analyzed. Results MR/signs of vestibu- lar EH were positive in 35 of the 43 patients （81A0%）, negative in 4 patients （9.30%） and inclonclusive in 4 patients （9.30%）. MRI signs of cochlear EH were positive in 36 of the 43 patients （83.72%）, negative in 3 patients （6.98%） and inconclusive in 4 patients （9.30%）. Conclusion After intratympanic injection of gadolinium, inner ear MRI is a practical and reliable method for detecting EH in MD. The main influencing factors include obstruction of contrast agent diffusing into the inner ear, techniques of intratympanic administration, MRI detection sequences and physician judgment factors.

关 键 词：梅尼埃病 内淋巴积水 MRI 钆喷酸葡胺 

分 类 号：R445[医药卫生—影像医学与核医学]