梅尼埃病患者内耳内淋巴间隙显像与临床特征的相关性研究  

Relative analysis of endolymphatic imaging and clinical manifestations in Meniere's patients

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

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

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第8期608-611,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨梅尼埃病患者组内耳内淋巴间隙显像与临床特征(上次眩晕发作结束距MRI扫描时间)的相关性。方法:梅尼埃病患者26例29侧患耳,根据患者的临床特征,将受试者分为A组和B组。其中,A组为MRI扫描时无眩晕发作且距上次眩晕发作结束>14d的患者,共12例14侧耳;B组为扫描时处于眩晕发作期或距上次眩晕发作结束≤14d的患者,共14例15侧耳。在鼻内镜引导下,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1d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。结果:26例梅尼埃病患者共29侧患耳经咽鼓管中耳腔给药成功。其中26侧患耳前庭及耳蜗内淋巴间隙均得到显影;B组3例患者(例6、例12、例14)的扫描图像中,其耳蜗和半规管均得到增强显影,而前庭未显影。A组前庭均值为0.37±0.06,耳蜗均值为0.15±0.04;B组前庭均值为0.52±0.26,耳蜗均值为0.18±0.06。ANOVA结果显示,两组前庭均值比较差异有统计学意义(P<0.05),耳蜗均值比较差异无统计学意义(P>0.05)。其中A组耳蜗内淋巴积水阳性率为7.1%,前庭内淋巴积水阳性率为42.9%;B组耳蜗内淋巴积水阳性率为13.3%,前庭内淋巴积水阳性率为66.7%。B组4例梅尼埃病发作期患者(例3、例5、例6、例14)耳蜗内淋巴积水阳性率为50%,前庭内淋巴积水阳性率为100%。B组前庭内淋巴积水阳性率高于A组。结论:梅尼埃病患者临床特征与MRI扫描诊断阳性率相关,发作期距扫描时间近或处于发作期患者MRI检查的阳性率高。Objective：The research aimed to study the relationship between endolymphatic imaging and clinical manifestations（duration of last attack period to MRI scan） of Meniere＇s patients. Method：Twenty-six Meniere＇s pa- tients and 29 affected ears were enrolled in this research. According to clinical manifestations, when performing MRI scan, patients who were not in attack period and the duration of last attach period to MRI scan was longer than 14 days were divided to Group A; and patients who were in attack period or the duration of last attach period to MRI scan was shorter than or equal to 14 days were divided to Group B. Administrate gadolinium to mid-ear af- fected by MD via non-invasive method through Eustachian tube, and then perform 3D-FLAIR MRI scan the next day. After measurement and calculation, compare RV and RC （area of endolymphatic space divided by total lym- phatic space in vestibule and cochlea, respectively） of the two groups. Result： Twenty-nine affected ears of 26 pa- tients were administrated successfully. The endolymphatic spaces were distinct from perilymphatic spaces in vesti- bule and cochlea in 26 ears. In the images of B6, B12, B14, the cochlea and semicircular canals were enhanced, but the vestibules were not enhanced. For Group A ,the average of RV was 0.37±0. 06; the average of RC was 0.15±0.04. As to Group B ,the average of RV was 0.52±0.26; the average of RC was 0.18±0.06. Accordingto ANOVA test, RV of the two groups had significant difference（P〈0.05）, RC had no significant difference（P〉 0.05）. The positive RC and RV in Group A were 7. 1% and 42.9% respectively. The positive RC and RV in Group B were 13.3% and 66.7%, respectively. As to 4 patients who were during attack period in Group B, the positive RC and RV were 50% and 100%, respectively. The positive RV of Group B was higher than that of Group A. Conclusion：The clinical manifestations（duration of last attack period to MRI scan） of Meniere＇s patients had relationship with positive rate of MRI

关 键 词：内淋巴显像 梅尼埃病 磁共振成像 钆喷酸葡胺 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]