内耳钆造影MRI前庭导水管显影的观察及临床意义  

Observation and clinical significance of visualization in gadolinium-contrast MRI of vestibular aqueduct

作　　者：赖艳梅 刘颖[1] 方哲明[1] 曹代荣[1] Lai Yanmei;Liu Ying;Fang Zheming;Cao Dairong(Departments of Imaging,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院影像科,福州350005

出　　处：《中华解剖与临床杂志》2020年第6期628-633,共6页Chinese Journal of Anatomy and Clinics

基　　金：福建省自然科学基金资助项目(2011J01161)

摘　　要：目的探讨经鼓室内耳钆造影MRI前庭导水管显影率及其临床意义。方法回顾性分析。纳入2010年2月—2018年1月福建医科大学附属第一医院影像科691例经鼓膜穿刺注射行内耳钆造影MRI的患者造影前后MRI及临床资料,其中男300例、女391例,年龄9~82岁。691例中,531例双侧、160例单侧(共1 222侧)行内耳钆造影。临床表现为眩晕483例、突发性耳聋125例、头晕42例、耳鸣39例、无症状2例,按症状有无进行分组观察。观察患者MRI图像,与造影前相比,造影后前庭导水管区信号升高即判定有显影,否则为无显影;另外,采用目测评分法评价内耳膜迷路是否积水。采用χ2检验分析眩晕组与非眩晕组、突聋组与非突聋组、耳鸣组与非耳鸣组之间前庭导水管显影发生率是否有差异,应用列联相关系数分析前庭导水管显影与膜迷路积水之间的关系。结果全组691例1 222耳中,26.8%(327/1 222耳)可见膜迷路积水,7.4%(90/1 222耳)可见前庭导水管显影。眩晕组6.0%(56/938耳)可见前庭导水管显影,非眩晕组12.0%(34/284耳)可见显影,差异有统计学意义(χ2=11.509,P<0.01);突聋组10.2%(19/186耳)可见前庭导水管显影,非突聋组6.9%(71/1 036耳)可见显影,差异无统计学意义(χ2=2.612,P>0.05);耳鸣组4.0%(6/149耳)可见前庭导水管显影,非耳鸣组7.9%(85/1 073耳)可见显影,差异无统计学意义(χ2=2.880,P>0.05)。眩晕组30.1%(282/938耳)可见膜迷路积水,非眩晕组15.8%(45/284耳)可见膜迷路积水,差异有统计学意义(χ2=22.488,P<0.01)。出现膜迷路积水的耳中3.1%(10/327耳)可见前庭导水管显影,无膜迷路积水的耳中8.9%(80/895耳)可见显影,差异有统计学意义(χ2=12.139,P<0.01);前庭导水管显影与膜迷路积水之间存在负相关关系(r=-0.099,P<0.01)。结论鼓室法内耳钆造影MRI图像上,钆对比剂可以进入前庭导水管,显影率约7.4%;骨性前庭导水管内存在外淋巴间隙;内耳钆造影MRI图像上前Objective This study aims to examine vestibular aqueduct visualized in the gadolinium-enhanced MRI of the inner ear and explore the clinical significance of visualization.Methods The MRI of the inner ear before and after intratympanic gadolinium injection and the clinical data of 691 patients(including 300 males and 391 females,aged 9-82 years,531 bilateral and 160 unilateral)who underwent MRI gadolinium angiography(tympani puncture)in the inner ear due to vertigo or sudden deafness in the Department of Imaging of the First Affiliated Hospital of Fujian Medical University was analyzed retrospectively.The main clinical manifestations included vertigo(n=483),sudden deafness(n=125),dizziness(n=42),tinnitus(n=39),and normal(n=2).The MR images were assessed by two experienced radiologists:(1)Compared with the images performed before gadolinium injection,the increased signal in the gadolinium-enhanced images of the vestibular aqueduct area was considered visualization.(2)The presence of endolymphatic hydrops was evaluated by visual scoring system.The incidence of vestibular aqueduct visualization in all patients in the gadolinium-enhanced magnetic resonance images was summarized.Chi-square test was used to analyze whether the incidence was different in patients between vertigo and non-vertigo,sudden deafness and non-sudden deafness,or membranous labyrinth with or without hydrops in the inner ear.Contingency correlation coefficient was used to analyze the correlation between vestibular aqueduct visualization and endolymphatic hydrops.Results In all MR images of the inner ear after intratympanic gadolinium injection,endolymphatic hydrops were seen in 26.8%(327/1222).The visualization rate of the vestibular aqueduct was 7.4%(90/1222).The visualization rates were 6.0%(56/938)in vertigo ear and 12.0%(34/284)in non-vertigo ear,and the difference was statistically significant(χ2=11.509,P<0.01).The visualization was observed in 10.2%(19/186)of ears with sudden deafness and 6.9%(71/1036)of ears without sudden deafness,with no

关 键 词：前庭水管 磁共振成像 内耳 造影 内淋巴积液 

分 类 号：R445.2[医药卫生—影像医学与核医学] R764.3[医药卫生—诊断学]