山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (2): 39-42.doi: 10.6040/j.issn.1673-3770.0.2017.005

• 论著 • 上一篇    下一篇

梅尼埃病患者内耳内淋巴间隙的比值与正常受试者的比较

刘旭晖1,2,黄魏宁1,2,孟曦曦3,刘芳1,陈敏4,傅元4,张晨4,张媛媛4   

  1. 1.北京医院 国家老年医学中心 耳鼻咽喉科, 北京100730;
    2.北京协和医学院研究生院, 北京 100730;
    3.北京市耳鼻咽喉科研究所, 北京 100730;
    4.北京医院 国家老年医学中心 放射科, 北京 100730
  • 收稿日期:2017-01-03 出版日期:2017-04-16 发布日期:2017-04-16
  • 通讯作者: 黄魏宁. E-mail:13911596718@163.com

Comparison of endolymphatic spaces between patients suffering from menieres disease and normal volunteers.

  1. 1. Department of Otolaryngology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China;2. Graduate School of Peking Union Medical College, Beijing 100730, China;3. Beijing Institute of Otolaryngology, Beijing 100730, China;4. Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
  • Received:2017-01-03 Online:2017-04-16 Published:2017-04-16

摘要: 目的 通过无创性经咽鼓管中耳腔导入造影剂钆行内耳3D-FLAIR MRI扫描的方法,对梅尼埃病患者组受试者进行研究,得到该年龄组耳蜗及前庭内耳内淋巴间隙的比值,并与20~55岁组正常值进行比较。 方法 在鼻内窥镜引导下,将稀释的钆喷酸葡胺注射液通过咽鼓管注入患耳中耳腔,给药1 d后行3D-FLAIR MRI扫描,得到内耳内淋巴间隙的显影,并对内耳内淋巴间隙、总淋巴间隙进行测量和计算,得到内耳内淋巴间隙与总淋巴间隙的比值,并与正常受试者组数据进行比较。 结果 在患者3D-FLAIR MRI扫描图像中可见耳蜗及前庭部内耳内淋巴间隙显影。对患者组3D-FLAIR MRI图像进行总淋巴间隙面积和内淋巴间隙面积的测量和计算,内淋巴间隙与总淋巴间隙面积之比为内耳内淋巴间隙的比值(前庭为RV,耳蜗为RC)。前庭内耳内淋巴间隙的比值为0.39±0.07, 耳蜗内耳内淋巴间隙的比值为0.16±0.05。与20~55岁正常受试者组比较,两组RV差异有统计学意义(t=-6.07,P<0.05);两组的RC无统计学差异(t=0.783,P>0.05)。依据刘芳等提出的内耳内淋巴积水的诊断标准(RV>39%,RC>27%),梅尼埃病患者组前庭内淋巴间隙积水阳性率为42.9%,耳蜗内淋巴积水阳性率为9.52%。处于梅尼埃病发作期的两位患者RV值测量均为阳性。 结论 梅尼埃病患者组与正常受试者组相较,两组RV值有显著差异,患者组RV值明显大于正常受试者组;两组RC值无明显差异。前庭内淋巴积水诊断阳性率为42.9%,2例发作期患者均存在前庭内淋巴积水阳性;耳蜗内淋巴积水诊断阳性率为9.52%。

关键词: 梅尼埃病, 磁共振成像, 经咽鼓管给药, 内耳淋巴显像, 钆喷酸葡胺

Abstract: Objective To compare the endolymphatic spaces between Menieres disease(MD)group and normal volunteer group. Methods Patients were performed administration of gadolinium to mid-ear affected by MD via non-invasive method through eustachian tube, and then performed 3D-FLAIR MRI scanning afer one day. After measurement and calculation, the RV and RC(area of endolymphatic space divided by total lymphatic space in vestibule and cochlea, respectively)between the MD group and the normal group were compared. Results The endolymphatic spaces were distinct from perilymphatic spaces in vestibule and cochlea, the average of RV was 0.39, and the standard deviation of RV was 0.07; the average of RC was 0.16, and the standard deviation of RC was 0.05. RV of the MD group had significant difference compared to that of the normal group(t=-6.07, P<0.05); RC of the MD group had no significant difference compared to that of the normal group(t=0.783, P>0.05). According to diagnosis standard raised by Liu F in previous research, the positive ratio of RV was 42.9%, while the positive RC was 9.52%. The two patients during attack period both had positive RVs. Conclusion RV of the MD group had significant difference compared to that of the normal group; RC of the MD group had no significant difference compared to that of the normal group.

Key words: Gadolinium, Endolymphatic imaging, Menieres disease, Magnetic resonance imaging, Administration through eustachian tube

中图分类号: 

  • R764.4
[1] Nakashima T, Naganawa S, Sugiura M, et al. Visualization of endolymphatic hydrops in patients with Menieres Disease[J]. The Laryngoscope, 2007, 117(3):415-420.
[2] 刘芳,黄魏宁,宋海涛, 等.梅尼埃病的内淋巴显像[J].中国科学院报,2008,30(6):651-654. LIU Fang, HUANG Weining, SONG Haitao, et al. Endolymphatic visualization in patients with Menieres Disease[J]. Acta Academiae Medicina Sinicae, 2008, 30(6):651-654.
[3] 刘芳, 余力生, 黄魏宁,等. 梅尼埃病的内淋巴积水显像[J].中华耳鼻咽喉头颈外科杂志, 2010,45(4):324-327. LIU Fang, YU Lisheng, HUANG Weining, et al. Non-invasive visualization of endolymphafic hydrops in patients with Menieres disease[J]. Chin J Otorhinolaryngol, 2010, 45(4):324-327.
[4] Liu F, Huang WN, Wang ZC, et al. Noninvasive evaluation of endolymphatic space in healthy volunteers using magnetic resonance imaging[J]. Acta Otolaryngol, 2011, 131(3):247-257.
[5] 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.
[6] Nakashima T, Naganawa S, Pyykko I, et al. Grading of endolymphatic hydrops using magnetic resonance imaging[J]. Acta Oto-Laryngologica, 2009, 4(560):5-8.
[7] Gurkov R, Flatz W, Louza J, et al. In vivo visualization of endolymphatic hydrops in patients with Menieres disease:correlation with audiovestibular function[J]. Eur Arch Otorhinolaryngol, 2011, 268(12):1743-1748.
[8] Fang ZM, Chen X, Gu X, et al. A new magnetic resonance imaging scoring system for perilymphatic space appearance after intratympanic gadolinium injection, and its clinical application[J]. J Laryngol Otol, 2012, 126(5):454-459.
[9] 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. CHEN Xi, ZHANG Xiaodong, GU Xi, et al. Diagnostic value and clinical application of innerear imaging after an intratympanic injection of gadolinium for Meniere's disease[J]. Natl Med J Chin, 2011, 91(46):3246-3249.
[10] 张道宫,史宏璐,樊兆民,等. 经鼓室钆注射内耳成像磁共振检查在梅尼埃病中的应用[J].中华耳鼻咽喉头颈外科杂志,2013,48(8):628-633. ZHANG Daogong, SHI Honglu, FAN Zhaomin, et al. Visualization of endolymphatic hydrops in 3D-·FLAIR MRI after intratympanic Gd·-DTPA administration in Menieres disease patients[J]. Chin J Otorhinolaryngol Head Neck Surg, 2013, 48(8):628-633.
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