梅尼埃病的内淋巴积水显像

目的 采用无创性技术经咽鼓管鼓室内导入造影剂钆,进行内耳三维快速液体衰减反转恢复磁共振扫描(three dimensional fluid attenuated inversion recovery magnetic resonance imaging,3D-FLAIR MBI),探讨梅尼埃病内淋巴间隙的显像.方法 7例梅尼埃病患者患侧经咽鼓管鼓室内导入钆喷酸葡胺稀释液,24 h后进行内耳3D-FLAIR MRI.全部患者于造影剂导入前、导人后24 h及3个月时分别进行纯音测听和鼓室声导抗检查.结果 5例患者内耳3D-FLAIR MRI显示造影剂钆广泛分布于患侧耳蜗、前庭和(或)半规管的外淋巴,可以区分内、外淋巴间隙的边界,清晰显像内淋巴情况;2例患者患侧包围内淋巴的外淋巴间隙缩小或消失(即不显影),提示内淋巴积水的存在.5例患侧中耳鼓室腔内未见造影剂钆增强;2例患侧部分中耳乳突腔内可见造影剂钆增强,而内耳未见明显增强.所有患者造影剂给药前和给药后24 h纯音测听平均听阈无明显变化;给药前、给药后24 h及3个月时鼓室声导抗结果无明显变化.结论 经咽鼓管鼓室内导入造影剂钆进行内耳3D-FLAIR MRI扫描,可以了解梅尼埃病患者内淋巴间隙情况.

Non-invasive visualization of endolymphatic hydrops in patients with Meniere's disease

Objective To visualize the endolymph in Meniere's disease by applying for noninvasive intratympanic gadolinium through eustachian tube and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) .Methods With a 3 Tesla magnetic resonance imaging (MRI) unit,3D-FLAIR imaging was performed 24 h after intratympanic gadolinium through eustachian tube in seven patients with Meniere's disease.Pure tone test was performed 24 h before and afteradministered gadolinium.Tympanometry was performed 24 h before,24 h and 3 months after administerad gadolinium.Results In five patients,the gadolinium could appear in parts of the perilymph inside the inner ear but not in the middle ear and mastoid,moreover,the border between the perilymph and endolymph was visible so that endolymphatic space was clearly shown on 3D-FLAIR imsging.In two patients with endolymphatic hydrops,the perilymphatic space surrounding endolymph was small or disappeared.In two patients,the gadolinium could appear in parts of the middle ear and mastoid but not in the inner ear.No significant changes in pure tone test and tympanometry were noted.Conclusions 3D-FLAIR MRI with intratympanic gadolinium through eustachian tube could clearly reveal the visualization of endolymphatic space in Meniere's disease.