梅尼埃病患者内耳内淋巴间隙的比值与正常受试者的比较  

Comparison of endolymphatic spaces between patients suffering from meniere's disease and normal volunteers

作　　者：刘旭晖[1,2] 黄魏宁[1,2] 孟曦曦[3] 刘芳[1] 陈敏[4] 傅元[4] 张晨[4] 张媛媛[4] 

机构地区：[1]北京医院国家老年医学中心耳鼻咽喉科,北京100730 [2]北京协和医学院研究生院,北京100730 [3]北京市耳鼻咽喉科研究所,北京100730 [4]北京医院国家老年医学中心放射科,北京100730

出　　处：《山东大学耳鼻喉眼学报》2017年第2期39-42,48,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的通过无创性经咽鼓管中耳腔导入造影剂钆行内耳3D-FLAIR MRI扫描的方法,对梅尼埃病患者组受试者进行研究,得到该年龄组耳蜗及前庭内耳内淋巴间隙的比值,并与20~55岁组正常值进行比较。方法在鼻内窥镜引导下,将稀释的钆喷酸葡胺注射液通过咽鼓管注入患耳中耳腔,给药1 d后行3D-FLAIR MRI扫描,得到内耳内淋巴间隙的显影,并对内耳内淋巴间隙、总淋巴间隙进行测量和计算,得到内耳内淋巴间隙与总淋巴间隙的比值,并与正常受试者组数据进行比较。结果在患者3D-FLAIR MRI扫描图像中可见耳蜗及前庭部内耳内淋巴间隙显影。对患者组3D-FLAIR MRI图像进行总淋巴间隙面积和内淋巴间隙面积的测量和计算,内淋巴间隙与总淋巴间隙面积之比为内耳内淋巴间隙的比值(前庭为RV,耳蜗为RC)。前庭内耳内淋巴间隙的比值为0.39±0.07,耳蜗内耳内淋巴间隙的比值为0.16±0.05。与20~55岁正常受试者组比较,两组RV差异有统计学意义(t=-6.07,P<0.05);两组的RC无统计学差异(t=0.783,P>0.05)。依据刘芳等提出的内耳内淋巴积水的诊断标准(RV>39%,RC>27%),梅尼埃病患者组前庭内淋巴间隙积水阳性率为42.9%,耳蜗内淋巴积水阳性率为9.52%。处于梅尼埃病发作期的两位患者RV值测量均为阳性。结论梅尼埃病患者组与正常受试者组相较,两组RV值有显著差异,患者组RV值明显大于正常受试者组;两组RC值无明显差异。前庭内淋巴积水诊断阳性率为42.9%,2例发作期患者均存在前庭内淋巴积水阳性;耳蜗内淋巴积水诊断阳性率为9.52%。Objective To compare the endolymphatic spaces between Meniere＇s disease （MD） group and normal volunteer group. Methods Patients were performed administration of gadolinium to mid-ear affected by MD via non-inva- sive method through eustachian tube, and then performed 3D-FLAIR MRI scanning afer one day. After measurement and calculation, the RV and RC （ area of endolymphatic space divided by total lymphatic space in vestibule and cochlea, respectively） between the MD group and the normal group were compared. Results The endolymphatic spaces were distinct from perilymphatic spaces in vestibule and cochlea, the average of RV was 0.39, and the standard devia- tion of RV was 0.07 ; the average of RC was 0.16, and the Standard deviation of RC was 0.05. RV of the MD group had significant difference compared to that of the normal group（ t = -6. 07, P 〈0.05） ; RC of the MD group had no significant difference compared to that of the normal group （ t = 0. 783, P 〉 0.05 ）. According to diagnosis standard raised by Liu F in previous research, the positive ratio of RV was 42.9%, while the positive RC was 9.52%. The two patients during attack period both had positive RVs. Conclusion RV of the MD group had significant difference compared to that of the normal group; RC of the MD group had no significant difference compared to that of the normal group.

关 键 词：内耳淋巴显像 梅尼埃病 磁共振成像 钆喷酸葡胺 经咽鼓管给药 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]