梅尼埃病内淋巴积水MRI影像诊断评价及影响因素分析_杨凤

·临床研究·

梅尼埃病内淋巴积水MRI 影像诊断评价

及影响因素分析

杨凤1,2刘阳2王庆军3赵丹珩2赵鹏举2孙建军2宋任东1

1.保定市第二中心医院耳鼻喉科涿州072750

2.海军总医院全军耳鼻喉科中心北京100048

3.海军总医院放射影像科北京100048【摘要】目的针对拟诊为梅尼埃病的患者，以MRI 检测内淋巴积水为方法，探讨在梅尼埃病诊断中以此方法确诊为内淋巴积水的可行性，并评估临床诊断价值，分析影响判定结果的相关因素。方法选择2013.6月-201

4.11月间住院病人梅尼埃病43例做为研究对象，经鼓室注射钆喷酸葡胺造影剂24小时后进行内耳MRI 检查，MRI 扫描序列为T1加权三维自旋回波序列(3D-FSE-T1WI),所得图像以前庭和耳蜗底

转各自内淋巴面积占内外淋巴面积之和的比率大于1/3为阳性，应用三分法进行定性判定，进行计数并统计。结果在43例梅尼埃病中，35例（81.40%）在前庭发现内淋巴积水，4例（9.30%）未发现积水，另外4例（9.30%）不能确定；在耳蜗，36例（83.72%）发现内淋巴积水，3例（6.98%）未发现积水，另外4例（9.30%）不能确定。结论鼓室内注射顺磁性造影剂后内耳MRI 检查可发现内淋巴积水，是临床确定内淋巴积水有效和可行的方法。其主要影响因素包括造影剂进入内耳受阻扩散不良、鼓室给药技术、MRI 检测技术及主观判定因素。

【关键词】梅尼埃病；内淋巴积水；MRI ；钆喷酸葡胺Factors affecting 3T MRI in Detecting Endolymphatic Hydrops

in Meniere ’s Disease

【Abstract 】Objective The aim of this study was to discuss feasibility and reliability of 3T MRI in detect-ing endolymphatic hydrops (EH)in Meniere ’s disease (MD).Another aim was to assess factors that might af-fect study results.Methods Forty-three patients with unilateral clinically confirmed MD were evaluated with inner ear MRI.MRI imaging was completed 24h after intratympanic administration of gadolinium chelate.The sequence of MRI was three-dimensional fast spin-echo T1-weighted imaging (3D-FSE-T1WI).A 3-point scoring system was used in the assessment of EH.Positive results were analyzed.Results MRI signs of vestibu-lar EH were positive in 35of the 43patients (81.40%),negative in 4patients (9.30%)and inclonclusive in 4pa-tients (9.30%).MRI signs of cochlear EH were positive in 36of the 43patients (83.72%),negative in 3pa-tients (6.98%)and inconclusive in 4patients (9.30%).Conclusion After intratympanic injection of gadolinium,inner ear MRI is a practical and reliable method for detecting EH in MD.The main influencing factors include obstruction of contrast agent diffusing into the inner ear,techniques of intratympanic administration,MRI de-tection sequences and physician judgment factors.

【Key words 】Meniere's disease ；endolymphatic hydrops,；MRI ，gadolinium.

【中图分类号】R445【文献标识码】A

【文章编号】1672-2922（2015）03-493-04

Corresponding author :LIU Yang Email:liuyangdoc@

1.Department of Otolaryngology,Second Center of Baoding City Hospital,Zhuozhou 072750

2Department of otolaryngology,PLA Navy General Hospital,Beijing 1000483Department of Radiology Imaging,PLA Navy General Hospital,Beijing 100048

YANG Feng 12，LIU Yang 2，Wang Qingjun 3,ZHAO Danheng 2,ZHAO Pengju 2,SUN Jianjun 2,SONG Rendong 1

DOI:10.3969/j.issn.1672-2922.2015.03.024

作者简介：杨凤，学士学位，主治医生，研究方向：耳科学通讯作者：刘阳，Email :liuyangdoc@