外淋巴间隙钆成像在梅尼埃病诊断中的价值  

Diagnostic value of MR imaging after intratympanic administration of contrast media in Meniere’s disease

作　　者：张丽红[1] 刘晓龙 李璐[2] 李晓瑜[2] 陈月芹[2] 王林省[2] ZHANG Lihong;LIU Xiaolong;LI Lu;LI Xiaoyu;CHEN Yueqin;WANG Linsheng(Jining No.1 People's Hospital&the Affiliated Hospital of Jining Medical University,Jining 272011,China;Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属济宁市第一人民医院,济宁272011 [2]济宁医学院附属医院,济宁272029

出　　处：《济宁医学院学报》2020年第1期49-53,共5页Journal of Jining Medical University

基　　金：2013年济宁市科技项目(2013jnwk118)。

摘　　要：目的探讨外淋巴间隙钆成像对梅尼埃病(Meniere’s disease,MD)的诊断价值。方法对35例经临床确诊的单侧MD患者行经鼓膜穿刺鼓室内注入Gd-DTPA稀释液,24h后行三维快速液体衰减反转恢复磁共振扫描,对内耳外淋巴间隙显示情况进行评分,并测量双侧前庭显影范围。结果IT-Gd 24h后,所有患者内耳3D-FLAIR MRI均显示钆对比剂分布于外淋巴间隙内,可清晰对比显示内淋巴间隙。患侧与健侧内耳外淋巴间隙评分值分别为6~16分(中位数10分)、15~18分(中位数17分),前庭显影范围分别为(9.20±2.61)mm2、(14.51±1.99)mm2,差异均具有统计学意义(P<0.001)。前庭面积测量法诊断MD的最佳界值点为11.23mm2,特异度为94.29%,灵敏度为82.86%;评分法诊断MD的最佳界值点为15分,特异度为94.29%,灵敏度为97.14%。结论外淋巴间隙钆成像可显示出膜迷路积水,为MD的诊断提供了直接影像依据,主观评分法和前庭显影面积测量法均能很好地反映内淋巴积水的情况。Objective To explore the diagnostic value of MR imaging after intratympanic gadolinium(ITGd)administration in Meniere’s disease.Methods Twenty-four hours after IT-Gd administration,35 patients with unilateral Meniere’s disease diagnosed clinically underwent IT-Gd 3 D-FLAIR scanning.The enhanced imaging of perilymphatic space was observed.The inner ears were scored respectively.The enhanced range of bilateral vestibule was measured.Results The gadolinium appeared in almost all parts of the perilymph in cochlea,vestibular and/or canal,so the endolymphatic space was clearly visualized on 3 D-FLAIR imaging.The score of the inner ears between the affected side and the healthy side were 6 to16(median10)and15 to 18(median17),and the area of enhanced vestibular were 9.20±2.61 mm^2 and 14.51±1.99 mm^2 for the affected side and the healthy side,which were significantly different(P<0.001).Tangent point of score and area measuring for the diagno sis of MD were 15 and 11.23.Specificity and sensitivity of summation score for the diagnosis of MD were 94.29%and 97.14%,meanwhile the specificity and sensitivity of area measuring of enhanced vestibular were 94.29%and 82.86%.Conclusion IT-Gd 3 D-FLAIR MRI can demonstrate the endolymphatic hydrops and has become an important diagnostic method for MD.MRI score has advantage over the area measuring of enhanced vestibular in the diagnosis of MD.

关 键 词：梅尼埃病 钆DTPA 磁共振成像 内淋巴积液 

分 类 号：R445.2[医药卫生—影像医学与核医学]