经静脉内耳钆造影MRI对可疑梅尼埃病的诊断价值  

Diagnostic Value of Intravenous Gadolinium Inner Ear MRI in Suspected Meniere’s Disease

作　　者：于学文 孙立新[1] 胡娜[1] 李进叶 田静[1] 赵慧[1] 巩若箴[1] Yu Xuewen;Sun Lixin;Hu Na;Li Jinye;Tian Jing;Zhao Hui;Gong Ruozhen(Department of Radiology,Shandong Provincial ENT Hospital,Shandong Provincial ENT Hospital Affiliated to Shandong University,Ji’nan,250022,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,济南250022

出　　处：《听力学及言语疾病杂志》2020年第4期380-383,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨经静脉内耳钆造影核磁共振(MRI)检查对可疑梅尼埃病(Ménière’s disease)的诊断价值。方法回顾性分析130例可疑梅尼埃病患者的临床资料,以2017年梅尼埃病诊断和治疗指南作为诊断标准,评价经静脉内耳钆造影MRI检查对梅尼埃病诊断的价值。结果 130例可疑梅尼埃病患者中,临床确诊为梅尼埃病80例,突聋21例,前庭性偏头痛20例,迟发型迷路积水等其他疾病9例。80例梅尼埃病患者中,内耳钆造影阳性68例,阴性12例;50例非梅尼埃病患者中,内耳钆造影阳性9例,阴性41例。内耳钆造影诊断梅尼埃病的灵敏度、特异度、阳性预测值和阴性预测值分别为88.3%、77.4%、85.0%、82.0%;经静脉内耳钆造影ROC曲线下面积及95%可信区间为83.5%(76.4%~89.7%);经静脉内耳钆造影诊断结果与临床诊断结果的一致性较好(κ=0.66)。结论经静脉内耳钆造影可以作为一种诊断梅尼埃病的可靠的无创性检查方法。Objective To evaluate the diagnostic value of intravenous gadolinium inner ear MRI in suspected Ménières disease. Methods We retrospectively analyzed the data of 130 suspected patients with Meniere’s disease. The diagnostic criteria were based on the 2017 guidelines for the diagnosis and treatment of Meniere’s disease, the diagnostic value of inner ear MRI in Meniere’s disease was evaluated. Results Of the 130 suspected patients, 80 patients were diagnosed as Meniere’s disease, 21 patients were diagnosed as sudden deafness, 20 patients were diagnosed as vestibular migraine, 9 patients were diagnosed as delayed hydrolabyrinth and other diseases. In 80 patients with Meniere’s disease, intravenous gadolinium inner ear MRI was positive in 68 cases and negative in 12 cases, and in 50 other patients, intravenous gadolinium inner ear MRI was positive in 9 cases and negative in 41 cases. The sensitivity, specificity, positive predictive value and negative predictive value of intravenous gadolinium inner ear MRI in the diagnosis of Meniere’s disease were 88.3%, 77.4%, 85.0% and 82.0%, respectively. The area under the ROC curve and 95% confidence interval of intravenous internal ear gadolinium angiography were 83.5%(76.4%~89.7%), and the area and 95% confidence interval of intravenous internal ear gadolinium angiography were 83.5%(76.4%~89.7%). The diagnostic results of angiography were consistent with those of clinical diagnosis(κ=0.66). Conclusion Intravenous gadolinium inner ear MRI can be used as a reliable method for noninvasive diagnosis of Meniere’s disease.

关 键 词：梅尼埃病 诊断 经静脉内耳钆造影 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]