基于三维液体衰减反转恢复序列静脉增强内耳膜迷路图像的定量评估方法评价内淋巴积水的对比研究  

Comparative study of quantitative methods based on intravenous enhancement of 3D-FLAIR sequence for evaluation of endolymphatic hydrops

作　　者：林毅 张国伟[2] 王紫仪 张宗锐[1] 索红娜 李忠维[2] 廉伟[2] 杨本涛[1] Lin Yi;Zhang Guowei;Wang Ziyi;Zhang Zongrui;Suo Hongna;Li Zhongwei;Lian Wei;Yang Bentao(Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;CT/MR Room,Yantaishan Hospital of Yantai City,Yantai 264001,China)

机构地区：[1]首都医科大学附属北京同仁医院放射科,北京100730 [2]烟台市烟台山医院CT/MR室,烟台264001

出　　处：《中华放射学杂志》2022年第3期231-235,共5页Chinese Journal of Radiology

基　　金：北京市医院管理中心“登峰”计划专项(DFL20190203);北京市医管局临床医学“扬帆”计划发展专项(ZYLX201704)。

摘　　要：目的比较基于内耳三维快速液体衰减反转恢复序列(3D-FLAIR)静脉增强内耳膜迷路图像的3种定量评估方法对内淋巴积水的诊断价值。方法回顾性收集2017年10月至2019年4月就诊于首都医科大学附属北京同仁医院单侧耳源性眩晕患者86例。入组患者均采取单倍剂量静脉增强,延迟8 h采集内耳3D-FLAIR图像。采用3种评价方法,分别为计算前庭内淋巴间隙面积与整个前庭内、外淋巴间隙总面积的比值、椭圆囊与球囊面积的比值和前庭内淋巴间隙体积与整个前庭内、外淋巴间隙总体积的比值。采用配对t检验比较患侧与健侧耳前庭内淋巴/总淋巴面积比、球囊/椭圆囊面积比、前庭内淋巴/总淋巴体积比的差异。以临床诊断为金标准,采用受试者操作特征(ROC)曲线分析3种评估方法诊断内淋巴积水的效能。结果本组86例患者中临床确诊内淋巴积水65例。患侧耳与健侧耳前庭内淋巴/总淋巴面积比、球囊/椭圆囊面积比、前庭内淋巴/总淋巴体积比的差异均有统计学意义(t=9.93、7.22、8.20,P均<0.001)。ROC曲线显示前庭内淋巴/总淋巴面积比、球囊/椭圆囊面积比、前庭内淋巴及总淋巴体积比诊断内淋巴积水的曲线下面积分别为0.882、0.768、0.884(P均<0.001),两两间差异无统计学意义(P均>0.05)。结论前庭内淋巴/总淋巴面积比、球囊/椭圆囊面积比、前庭内淋巴/总淋巴体积比均可用于定量评估内淋巴积水,目前内淋巴/总淋巴面积比值法为最为简便易行的方法。Objective To compare the diagnostic value of three quantitative evaluation methods based on three-dimensional rapid fluid attenuation inversion recovery sequence(3D-FLAIR)vein-enhanced labyrinth images in endolymphatic hydrops.Methods From October 2017 to April 2019,a retrospective study was conducted on 86 patients with unilateral otogenic vertigo who were admitted to Beijing Tongren Hospital,Capital Medical University.MRI was performed 8 h after the single-dose Gd-DTPA intravenously injection in all patients.Three evaluation methods were used to calculate the ratio of the endolymphatic area to the total lymphatic area,the ratio of the saccule to utricle area,and the ratio of the endolymphatic volume to the total lymphatic volume,respectively.The paired t test was used to compare the three ratios between the affected and healthy ears.With clinical diagnosis as the gold standard,the receiver operating characteristic(ROC)curve analysis was used to analyze the efficacy of three methods in diagnosing endolymphatic hydrops.Results Totally 65 cases were finally diagnosed endolymphatic hydrops clinically.There were statistically significant differences of all the 3 ratios between the affected and healthy ears(t=9.93,7.22,8.20,all P<0.001).The ROC curve showed that the area under the curve(AUC)of endolymph/total lymph area ratio,saccule/utricle area ratio,endolymph/total lymph volume ratio for diagnosis of endolymphatic hydrops were 0.882,0.768,0.884(all P<0.001).And there were no significant differences between each paired AUCs(all P>0.05).Conclusions All three methods of endolymph/total lymph area ratio,saccule/utricle area ratio,endolymph/total lymph volume ratio can quantitatively evaluate endolymphatic hydrops.The endolymphatic/total lymphatic area ratio method is still the most convenient method at present.

关 键 词：内耳 球囊和椭圆囊 内淋巴积液 磁共振成像 

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]