梅尼埃病的内淋巴显像

目的运用无创性的经咽鼓管鼓室内导入造影剂钆技术,进行内耳三维快速液体衰减反转恢复核磁共振(3D-FLAIRMRI)扫描,探讨梅尼埃病内淋巴显像的可行性。方法2例顽固性、活动性梅尼埃病患者经咽鼓管鼓室内导入钆喷酸葡胺稀释液24h后进行内耳3D-FLAIRMRI。患者行钆喷酸葡胺溶液导入前、后24h分别进行纯音测听和鼓室导抗检查。结果内耳3D-FLAIRMRI显示造影剂钆可以分布到内耳外淋巴,并且可以区分内、外淋巴间隙的边界,清晰显像内淋巴情况;2例患者造影前、后24h纯音测听平均听阈值和鼓室导抗无变化。结论运用内耳3D-FLAIRMRI加咽鼓管鼓室内导入造影剂钆,可以显像梅尼埃病内淋巴情况;经咽鼓管鼓室内导入造影剂是安全、有效的给药新途径。

Endolymphatic Visualization in Patients with Meniere's Disease

Objective To attempt to visualize the endolymph in patients with Meniere's disease by applying non-invasive 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 hours after intratympanic gadolinium through eustachian tube in two patients with medically active and intractable Meniere's disease.Pure tone test and tympanometry were performed 24 hours before and after the administration of gadolinium.Results The gadolinium appeared in almost all parts of the perilymph inside the inner ear;moreover,the border between the perilymph and the endolymph was visible so endolymphatic space was clearly shown on 3D-FLAIR.No change in pure tone test and tympanometry was noted.Conclusions 3D-FLAIR MRI with intratympanic gadolinium through eustachian tube can clearly reveal the visualization of endolymph in patients with Meniere's disease.Intratympanic gadolinium therapy through eustachian tube is a safe and effective.