经鼓室和静脉途径给药后内耳3D-FLAIR MRI观察梅尼埃病迷路变化  

Trans-tympanum and intravenous administration of contrast agents 3D-FLAIR MR inner ear imaging in patients with Meniere’s disease

作　　者：李进叶 孙立新[1] 李龙[2] 赵慧[1] 许挺 田静[1] 胡娜[1] 黄一帆 巩若箴[3] LI Jinye;SUN Lixin;LI Long;ZHAO Hui;XU Ting;TIAN Jing;HU Na;HUANG Yifan;GONG Ruozhen(Department of Radiology,Shandong Provincial ENT Hospital,Shandong Provincial ENT Hospital Affiliated to Shandong University,Jinan 250000,China;Department of Medical,Shandong Provincial ENT Hospital,Shandong Provincial ENT Hospital Affiliated to Shandong University,Jinan 250000,China;Gong Ruozhen Innovation Studio,Shandong Medical Imaging Research Institute Affiliated to Shandong University,Jinan 250000,China)

机构地区：[1]山东省耳鼻喉医院山东大学附属山东省耳鼻喉医院影像科,山东济南250000 [2]山东省耳鼻喉医院山东大学附属山东省耳鼻喉医院医务部,山东济南250000 [3]山东大学附属山东省医学影像学研究所巩若箴创新工作室,山东济南250000

出　　处：《中国医学影像技术》2020年第1期46-49,共4页Chinese Journal of Medical Imaging Technology

基　　金：山东省重点研发计划(2017GSF18192)

摘　　要：目的比较经鼓室和静脉途径给药后三维快速液体衰减反转恢复磁共振成像(3D FLAIR MRI)显示梅尼埃病患者迷路变化的效果。方法将36例单侧梅尼埃病患者随机分成2组,静脉组经肘静脉(n=18)注射对比剂钆贝葡胺(GD-BOPTA),鼓室组(n=18)经双侧鼓膜分别注射等量稀释对比剂钆喷酸葡胺(Gd-DTPA),分别于4 h、24 h后行内耳3D FLAIR MR扫描,观察双侧迷路显影情况;在双侧耳蜗底转及同层脑干区域勾画ROI,分别计算并比较2组耳蜗底转及同层脑干的信号强度比值(CM比值);记录两种方法显示耳蜗、前庭内淋巴积水情况,对比2组CM比值及淋巴积水率差异。结果鼓室组患耳CM比值(1.86±0.74)与健耳CM比值(1.68±0.77)差异无统计学意义(P=0.805)。静脉组患耳CM比值(1.46±0.31)高于健耳(1.26±0.21,P=0.001)。鼓室组患耳CM比值(1.86±0.74)高于静脉组(1.46±0.31,n=18,P=0.044),健耳CM比值(1.68±0.77)高于静脉组(1.26±0.21,n=18,P=0.032)。结论经鼓室给药与静脉途径给药后内耳MRI观察梅尼埃病患者内淋巴积水效果相当;前者外淋巴间隙信号强度较高,后者可同时观察双侧内耳及血-迷路屏障渗透性,且创伤较小。Objective To observe the changes of inner ear in patients with Meniere's disease with 3D-FLAIR MRI after intratympanic(IT)gadolinium injection or intravenous(IV)gadolinium injection.Methods Totally 36 patients with Meniere's disease were randomly divided into 2 groups.Eighteen of them underwent intravenous injection of GD-BOPTA(IV group),while the rest 18 underwent bilateral IT injection of equivalent dilution of GD-DTPA(IT group).3D-FLAIR MR examinations were performed after 4 and 24 hours,respectively.ROIs in cochlear perilymph and medulla oblongata were drawn on MRI,and signal-intensity ratio(CM ratio)was subsequently evaluated and compared with paired t test.In addition,the ratio of endolymphatic hydrops(EH)of each group were separately observed and analyzed using chi-squared test.Results For IT group,comparable CM ratios were found between the affected and unaffected sides of perilymph regions(1.86±0.74 vs 1.68±0.77,n=18,P=0.805).For IV group,significant difference of CM ratios was observed between the affected and unaffected sides of perilymph regions(1.46±0.31 vs 1.26±0.21,n=18,P=0.001).Meanwhile,significantly higher CM ratio was shown in affected sides of perilymph in IT group than that in IV group(1.86±0.74 vs 1.46±0.31,n=18,P=0.044),and significantly higher CM ratio was found in unaffected sides of perilymph in IT group than that in IV group(1.68±0.77 vs 1.26±0.21,n=18,P=0.032).Conclusion Trans-tympanum administration and intravenous administration inner ear MRI show the same effect,and the former has higher signal intensity,while bilateral inner ear and blood-labyrinth barrier permeability could be observed using the latter with less injury.

关 键 词：梅尼埃病 磁共振成像 膜迷路积水 

分 类 号：R764.33[医药卫生—耳鼻咽喉科] R445.2[医药卫生—临床医学]