山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (6): 101-107.doi: 10.6040/j.issn.1673-3770.0.2020.504

• 综述 • 上一篇    下一篇

内耳钆造影磁共振成像技术在梅尼埃病诊疗中的应用

张瑶瑶,王海涛   

  1. 吉林大学第二医院 耳鼻咽喉头颈外科, 吉林 长春 130012
  • 发布日期:2021-12-10
  • 通讯作者: 王海涛. E-mail:herowht@qq.com

The application of MRI technology with intratympanic gadolinium injection in the diagnosis and treatment of Meniere's disease

ZHANG Yaoyao,WANG Haitao   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Jilin University, Changchun 130012, Jilin, China
  • Published:2021-12-10

摘要: 随着内耳钆造影磁共振成像技术的出现,为多种内耳疾病的诊断提供了新方法,也为梅尼埃病的诊断提供新契机,甚至有望成为其诊断的金标准。论文围绕国内外鼓室钆造影技术的发展现状,归纳了钆造影的磁共振成像技术特点、给药方式、评估方法及与传统检查方式进行了对比,总结了内耳钆造影磁共振成像技术在梅尼埃病诊疗中的研究现状。

关键词: 梅尼埃病, 钆造影, 内淋巴积水, 眩晕, 磁共振成像

Abstract: The emergence of magnetic resonance imaging(MRI)with intratympanic gadolinium injection in the inner ear provides a new diagnostic technique for a variety of inner ear diseases, hence a new method for diagnosis Meniere's disease, which is expected to become the gold standard for the diagnosis of the condition. Based on the developmental progress of MRI of with intratympanic gadolinium at home and abroad, this paper summarizes the characteristics of gadolinium MRI echnology, a variety of drug delivery methods, evaluation methods, and comparison with traditional examination methods, and summarizes the research status of inner ear gadolinium MRI technology in the diagnosis and treatment of Meniere's disease.

Key words: Meniere's disease, Intratympanic gadolinium, Endolymphatic hydrops, Vertigo, Magnetic resonance lmaging

中图分类号: 

  • R764.33
[1] 梅尼埃病诊断和治疗指南(2017)[C].中国中西医结合学会.中国中西医结合学会眩晕病专业委员会第二次学术大会暨河南省中西医结合学会眩晕病专业委员会第三次学术大会暨眩晕高峰论坛论文汇编.中国中西医结合学会,2017:111-117.
[2] Neuhauser H, Leopold M, von Brevern M, et al. The interrelations of migraine, vertigo, and migrainous Vertigo[J]. Neurology, 2001, 56(4): 436-441. doi:10.1212/wnl.56.4.436.
[3] 韩永平, 张俊义, 高霞, 等. 1.5T MRI条件钆造影在梅尼埃病患者中的临床应用[J]. 中华耳科学杂志, 2019, 17(6): 833-837. doi:10.3969/j.issn.1672-2922.2019.06.006. HAN Yongping, ZHANG Junyi, GAO Xia, et al. Clinical application of gadolinium angiography in patients with meniere disease under the condition of 1.5T MRI[J]. Chin J Otol, 2019, 17(6): 833-837. doi:10.3969/j.issn.1672-2922.2019.06.006.
[4] Naganawa S, Satake H, Kawamura M, et al. Separate visualization of endolymphatic space, perilymphatic space and bone by a single pulse sequence; 3D-inversion recovery imaging utilizing real reconstruction after intratympanic Gd-DTPA administration at 3 Tesla[J]. Eur Radiol, 2008, 18(5): 920-924. doi:10.1007/s00330-008-0854-8.
[5] 赵梦龙, 刘壮, 沙炎, 等. 高分辨率三维真实重建反转恢复序列和三维液体衰减反转恢复序列评估内淋巴积水的对比研究[J]. 中华放射学杂志, 2016, 50(8): 581-585. doi:10.3760/cma.j.issn.1005-1201.2016.08.005. ZHAO Menglong, LIU Zhuang, SHA Yan, et al. Visualization of endolymphatic Hydrops after intratympanic injection of Gd-DTPA: a comparison of high resolution three dimensional-real inversion recovery and three dimensional fluid-attenuated inversion recovery with a variable flip angle sequence[J]. Chin J Radiol, 2016, 50(8): 581-585. doi:10.3760/cma.j.issn.1005-1201.2016.08.005.
[6] Nakashima T, Naganawa S, Katayama N, et al. Clinical significance of endolymphatic imaging after intratympanic gadolinium injection[J]. Acta Otolaryngol Suppl, 2009(560): 9-14. doi:10.1080/00016480902729801.
[7] Niyazov DM, Andrews JC, Strelioff D, et al. Diagnosis of endolymphatic Hydropsin vivo with magnetic resonance imaging[J]. Otol Neurotol, 2001, 22(6): 813-817. doi:10.1097/00129492-200111000-00017.
[8] Zou J, Pyykkö I, Bretlau P, et al. In vivo visualization of endolymphatic Hydrops in Guinea pigs: magnetic resonance imaging evaluation at 4.7 tesla[J]. Ann Otol Rhinol Laryngol, 2003, 112(12): 1059-1065. doi:10.1177/000348940311201212.
[9] Naganawa S, Komada T, Fukatsu H, et al. Observation of contrast enhancement in the cochlear fluid space of healthy subjects using a 3D-FLAIR sequence at 3 Tesla[J]. Eur Radiol, 2006, 16(3): 733-737. doi:10.1007/s00330-005-0046-8.
[10] Naganawa S, Suzuki K, Yamazaki M, et al. Time course for measuring endolymphatic size in healthy volunteers following intravenous administration of gadoteridol[J]. Magn Reson Med Sci, 2014, 13(2): 73-80. doi:10.2463/mrms.2013-0080.
[11] 史夙铭, 孙文芳, 王武庆. 经静脉内耳钆造影证实的梅尼埃病的临床特征及钆造影特点[J]. 中华医学杂志, 2018, 98(16): 1218-1222. doi:10.3760/cma.j.issn.0376-2491.2018.16.006. SHI Suming, SUN Wenfang, WANG Wuqing. Clinical features and imaging characteristics of Meniere's disease verified by intravenous gadolinium contrast-enhanced magnetic resonance imaging[J]. Natl Med J China, 2018, 98(16): 1218-1222. doi:10.3760/cma.j.issn.0376-2491.2018.16.006.
[12] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.内耳内淋巴积水磁共振影像评估中国专家共识(2020)[J].中华耳鼻咽喉头颈外科杂志,2020,55(9):809-813.
[13] Zou J, Pyykkö I, Bjelke B, et al. Communication between the perilymphatic scalae and spiral ligament visualized by in vivo MRI[J]. Audiol Neurootol, 2005, 10(3): 145-152. doi:10.1159/000084024.
[14] Nakashima T, Naganawa S, Sugiura M, et al. Visualization of endolymphatic Hydrops in patients with Meniere's disease[J]. Laryngoscope, 2007, 117(3): 415-420. doi:10.1097/MLG.0b013e31802c300c.
[15] Uno A, Horii A, Imai T, et al. Endolymphatic Hydrops detected with inner ear gd contrast-enhanced MRI; comparison between administration routes or with ECochG or glycerol test[J]. Nihon Jibiinkoka Gakkai Kaiho, 2013, 116(8): 960-968. doi:10.3950/jibiinkoka.116.960.
[16] 李进叶, 孙立新, 李龙, 等. 经鼓室和静脉途径给药后内耳3D-FLAIR MRI观察梅尼埃病迷路变化[J]. 中国医学影像技术, 2020,36(1): 46-49. doi:10.13929/j.issn.1003-3289.2020.01.012. LI Jinye, SUN Lixin, LI Long, et al. Trans-tympanum and intravenous administration of contrast agents 3D-FLAIR MR inner ear imaging in patients with Meniere's disease[J]. Chin J Med Imaging Technol, 2020,36(1): 46-49. doi:10.13929/j.issn.1003-3289.2020.01.012.
[17] Yamazaki M, Naganawa S, Tagaya M, et al. Comparison of contrast effect on the cochlear perilymph after intratympanic and intravenous gadolinium injection[J]. AJNR Am J Neuroradiol, 2012, 33(4): 773-778. doi:10.3174/ajnr.A2821.
[18] Zou J, Pyykkö I. Calcium metabolism profile in rat inner ear indicated by MRI after tympanic medial wall administration of manganese chloride[J]. Ann Otol Rhinol Laryngol, 2016, 125(1): 53-62. doi:10.1177/0003489415597916.
[19] 刘芳, 黄魏宁, 宋海涛, 等. 梅尼埃病的内淋巴显像[J]. 中国医学科学院学报, 2008,30(6): 651-654. doi: CNKI:SUN:ZYKX.0.2008-06-007. LIU Fang, HUANG Weining, SONG Haitao, et al. Endolymphatic visualization in patients with Meniere's disease[J]. Acta Acad Med Sin, 2008,30(6): 651-654. doi: CNKI:SUN:ZYKX.0.2008-06-007.
[20] Liu F, Huang WN, Chen QH, et al. Comparison of noninvasive evaluation of endolymphatic space in healthy volunteers in different age groups using magnetic resonance imaging[J]. Acta Otolaryngol, 2015, 135(5): 416-421. doi:10.3109/00016489.2014.986760.
[21] 袁思殊, 夏黎明, 杨朝霞, 等. 磁共振钆对比剂有关安全性研究现状[J]. 磁共振成像, 2020,11(8): 717-720. doi: 10.12015/issn.1674-8034.2020.08.030. YUAN Sishu, XIA Liming, YANG Zhaoxia, et al. Research status of Gadolinium-based contrast on safety[J]. Chin J Magn Reson Imaging, 2020,11(8): 717-720. doi: 10.12015/issn.1674-8034.2020.08.030.
[22] Nakashima T, Naganawa S, Pyykko I, et al. Grading of endolymphatic Hydrops using magnetic resonance imaging[J]. Acta Otolaryngol Suppl, 2009(560): 5-8. doi:10.1080/00016480902729827.
[23] 陈曦, 张晓东, 顾晰, 等. 经鼓室钆注射内耳成像技术在梅尼埃病患者中的临床应用[J]. 中华医学杂志, 2011, 91(46): 3246-3249. doi:10.3760/cma.j.issn.0376-2491.2011.46.003. CHEN Xi, ZHANG Xiaodong, GU Xi, et al. Diagnostic value and clinical application of inner ear imaging after an intratympanic injection of gadolinium for Meniere's disease[J]. Natl Med J China, 2011, 91(46): 3246-3249. doi:10.3760/cma.j.issn.0376-2491.2011.46.003.
[24] Bernaerts A, Vanspauwen R, Blaivie C, et al. The value of four stage vestibular hydrops grading and asymmetric perilymphatic enhancement in the diagnosis of Menière's disease on MRI[J]. Head-Neck-ENT Radiology. 2019, 61(4): 421-429. doi:10.1007/s00234-019-02155-7.
[25] Gürkov R, Berman A, Dietrich O, et al. MR volumetric assessment of endolymphatic Hydrops[J]. Eur Radiol, 2015, 25(2): 585-595. doi:10.1007/s00330-014-3414-4.
[26] Kirsch V, Nejatbakhshesfahani F, Ahmadi SA, et al. A probabilistic atlas of the human inner ear's bony labyrinth enables reliable atlas-based segmentation of the total fluid space[J]. J Neurol, 2019, 266(Suppl 1): 52-61. doi:10.1007/s00415-019-09488-6.
[27] 章梦蝶, 金占国, 徐先荣, 等. 静脉甘油试验和鼓室钆造影在梅尼埃病诊断中的价值[J]. 中华耳科学杂志, 2016,14(4): 499-503. doi: 10.3969/j.issn.1672-2922.2016.04.014. ZHANG Mengdie, JIN Zhanguo, XU Xianrong, et al. Diagnostic values of intravenous glycerol test and inner ear imaging with intratympanic gadolinium injection in Meniere's disease[J]. Chin J Otol, 2016,14(4): 499-503. doi: 10.3969/j.issn.1672-2922.2016.04.014.
[28] 何白慧, 张帆, 孙夏雨, 等. 外耳道耳蜗电图对梅尼埃病患者的诊断价值[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 20-26. doi: 10.6040/j.issn.1673-3770.1.2020.073. HE Baihui, ZHANG Fan, SUN Xiayu, et al. Diagnostic value of electrocochleography using external auditory canal electrode in patients with Meniere's disease[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 20-26. doi: 10.6040/j.issn.1673-3770.1.2020.073.
[29] Hisakuni Fukuoka, Yutaka Takumi, Keita Tsukada, 等. 比较内耳内淋巴显像和耳蜗电图及甘油试验在梅尼埃病诊断中的价值[J]. 临床耳鼻咽喉头颈外科杂志, 2012,26(19): 893-896. doi:10.13201/j.issn.1001-1781.2012.19.016. Fukuoka H, Takumi Y, Tsukada K, et al. Comparison of the diagnostic value of 3 T MRI after intratympanic injection of GBCA, electrocochleography, and the glycerol test in patients with Meniere's disease[J]. J Clin Otorhinolaryngol Head Neck Surg, 2012,26(19): 893-896. doi:10.13201/j.issn.1001-1781.2012.19.016.
[30] 付佳, 区永康, 高志娟, 等. 三维液体衰减反转恢复序列磁共振成像在内耳疾病中的应用研究[J]. 中国耳鼻咽喉颅底外科杂志, 2018,24(4): 381-385. doi: 10.11798/j.issn.1007-1520.2018040018. FU Jia, OU Yongkang, GAO Zhijuan, et al. Application of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging for the diagnosis of inner ear diseases[J]. Chin J Otorhinolaryngol - Skull Base Surg, 2018,24(4): 381-385. doi: 10.11798/j.issn.1007-1520.2018040018.
[31] 严进, 成红政, 刘爱国. 梅尼埃病患者前庭内淋巴积水程度与其症状和听觉及前庭功能的相关性分析[J]. 听力学及言语疾病杂志, 2015, 23(3): 220-225. doi:10.3969/j.issn.1006-7299.2015.03.002. YAN Jin, CHENG Hongzheng, LIU Aiguo. The correlation analysis of endolymphatic Hydrops degree in vestibule and the symptoms and audiovestibular functions in patients with Meniere's disease[J]. J Audiol Speech Pathol, 2015, 23(3): 220-225. doi:10.3969/j.issn.1006-7299.2015.03.002.
[32] Guo P, Sun W, Shi S, et al. Quantitative evaluation of endolymphatic Hydrops with MRI through intravenous gadolinium administration and VEMP in unilateral definite Meniere's disease[J]. Eur Arch Otorhinolaryngol, 2019, 276(4): 993-1000. doi:10.1007/s00405-018-05267-7.
[33] Blödow A, Pannasch S, Walther LE. Detection of isolated covert saccades with the video head impulse test in peripheral vestibular disorders[J]. Auris Nasus Larynx, 2013, 40(4): 348-351. doi:10.1016/j.anl.2012.11.002.
[34] 林颖, 高林溪, 韩丽萍, 等. 视频头脉冲检查在评价外周前庭病变中的作用[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(9): 724-728. doi:10.3760/cma.j.issn.1673-0860.2015.09.005. LIN Ying, GAO Linxi, HAN Liping, et al. Video head impulse test in peripheral vestibular diseases[J]. Chin J Otorhinolaryngol Head Neck Surg, 2015, 50(9): 724-728. doi:10.3760/cma.j.issn.1673-0860.2015.09.005.
[35] 岑锦添, 张姝琪, 袁涛, 等. 视频头脉冲试验联合冷热试验评估半规管功能的初步研究[J]. 中华耳科学杂志, 2018, 16(3): 267-271. doi:10.3969/j.issn.1672-2922.2018.03.002. CEN Jintian, ZHANG Shuqi, YUAN Tao, et al. A preliminary study on semicircular canal function assessment by video head impulse test and caloric test[J]. Chin J Otol, 2018, 16(3): 267-271. doi:10.3969/j.issn.1672-2922.2018.03.002.
[36] de Oliveira LNDR, Oliveira CLDA, Lopes KDC, et al. Diagnostic assessment of patients with Meniere's disease through caloric testing and the video-head-impulse test[J]. Braz J Otorhinolaryngol, 2019. doi:10.1016/j.bjorl.2019.10.008.
[37] 刘宇鹏, 梁敏, 何景春, 等. 梅尼埃病前庭功能分级的探讨[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 14-19. doi: 10.6040/j.issn.1673-3770.1.2020.062. LIU Yupeng, LIANG Min, HE Jingchun, et al. A new grade of vestibular function abnormality in Meniere's disease: a pilot study, 2020, 34(5): 14-19. doi: 10.6040/j.issn.1673-3770.1.2020.062.
[1] 许嘉, 李欣, 陈雯婧, 高娟娟, 卢星星, 伊海金. 联合应用内淋巴囊减压和局部激素治疗难治性梅尼埃病的短期与长期疗效分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 17-21.
[2] 黄岚,高伟陈钢钢. 内耳疾病继发BPPV的发病机制和临床特征的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 108-113.
[3] 蒋黎娜,于倩如,于杰,关本岭,鹿玉,于淑东. 前庭性眩晕疾病患者焦虑和抑郁状况研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 1-5.
[4] 杨军, 郑贵亮. 外周前庭疾病的诊断和治疗[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 1-6.
[5] 刘宇鹏, 梁敏, 何景春, 郑贵亮, 李姝娜, 张青, 杨军. 梅尼埃病前庭功能分级的探讨[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 14-19.
[6] 何白慧, 张帆, 孙夏雨, 陈建勇, 王璐, 李姝娜, 陈向平, 杨军. 外耳道耳蜗电图对梅尼埃病患者的诊断价值[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 20-26.
[7] 刘宇鹏, 吴文瑾, 何景春, 郑贵亮, 张青, 杨军. 迷路后径路前庭神经切断术治疗难治性梅尼埃病75例[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 46-50.
[8] 陈建勇, 孙夏雨, 沈佳丽, 汪玮, 王璐, 贺宽, 张勤, 马孝宝, 沈敏, 陈向平, 杨军. 原发性良性阵发性位置性眩晕患者VEMP异常率的临床观察[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 51-55.
[9] 邓巧媚,王巍,温超,刘强,毛翔,韩曦,李姗姗,陈太生,徐开旭,林鹏. 头晕眩晕与眼震强度的关系研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 56-60.
[10] 王海霞,张彩霞,李银银,郑金秀,陈曦. 经鼓室注射内耳钆造影显影不良原因初探[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 61-66.
[11] 郑贵亮, 刘凌峰, 陈建勇, 张青, 杨军. 基于移动互联网的前庭康复训练指导平台的开发与应用[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 78-81.
[12] 赵欢娣,成颖杨军,张青. 3D-FLAIR MRI在内耳出血所致的SSNHL诊断中的作用[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 97-101.
[13] 魏馨雨,杨方园杨军,张青. 耳源性细菌性迷路炎研究进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 102-107.
[14] 王玥, 上官翰京 蔡成福. 睡眠对良性阵发性位置性眩晕影响的研究进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 108-112.
[15] 周卓华李红阳, 黄映湘, 王艳玲. 磁共振动脉自旋标记技术在缺血性疾病中的应用研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 16-22.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 邓基波,孙奉乾,许安廷 . 大前庭导水管综合征[J]. 山东大学耳鼻喉眼学报, 2006, 20(2): 116 -118 .
[2] 周子宁,金国威 . 喉气管狭窄的预防和治疗进展[J]. 山东大学耳鼻喉眼学报, 2006, 20(5): 462 -465 .
[3] 周斌,李滨 . 鼻内窥镜下鼻窦鼻息肉手术75例疗效观察[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 24 -26 .
[4] 徐赛男,杨雷 . 红霉素促进鼻息肉上皮细胞凋亡的实验研究[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 27 -29 .
[5] 张玉光,韩旭光,张华,王旭,徐湘辉 . 改良穿透性角膜移植术治疗真菌性角膜炎[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 94 -95 .
[6] 刘联合 . 颈深部脓肿37例[J]. 山东大学耳鼻喉眼学报, 2008, 22(2): 180 -181 .
[7] 谢治年 ,姬长友 . RNA干扰及其在喉鳞癌研究中的应用[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 200 -203 .
[8] 乔 艺,倪关森,陈文文 . 改良悬雍垂腭咽成形术联合鼻腔手术治疗阻塞性睡眠呼吸暂停综合征38例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 206 -208 .
[9] 汪晓锋,林 昶,程金妹 . 不同龄小鼠内耳中ABAD的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 207 -211 .
[10] 凡启军,黄治物,梅 玲,肖伯奎 . 荧光定量PCR测定水杨酸钠作用后大鼠耳蜗基因的表达[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 212 -214 .