CAJ | 학술논문

目的通过经鼓室内注射造影剂钆,行内耳三维快速液体衰减反转恢复核磁共振(3D-FLAIR MRI)扫描,探讨梅尼埃病膜迷路积水显像的阳性率及对于梅尼埃病的诊断价值.方法对2010年3月至2011年2月,福建医科大学附属第一医院耳鼻咽喉头颈外科51例梅尼埃病患者经鼓膜双侧鼓室内注入钆喷酸葡胺稀释液,24h后进行内耳3D-FLAlR MRI扫描,并对检查结果进行总结、分析,同时与前庭诱发的肌源性电位(VEMP)及甘油实验结果进行比较.结果磁共振成像显示造影剂钆分布到内耳外淋巴间隙,使外淋巴液显影增强,从而区分出内、外淋巴间隙.对梅尼埃病患者内耳膜迷路积水显示的阳性率为96.1％(49/51),与VEMP及甘油试验的阳性率相比差异有统计学意义(P＜0.05).51例患者随访未见鼓膜穿孔、感染等并发症.结论经鼓室钆注射内耳成像技术在梅尼埃病患者膜迷路积水中具有较高的阳性率,虽为有创性检查但不良反应较小,对于梅尼埃病具有重要的诊断价值和临床意义.
목적 통과경고실내주사조영제구,행내이삼유쾌속액체쇠감반전회복핵자공진(3D-FLAIR MRI)소묘,탐토매니애병막미로적수현상적양성솔급대우매니애병적진단개치.방법 대2010년3월지2011년2월,복건의과대학부속제일의원이비인후두경외과51례매니애병환자경고막쌍측고실내주입구분산포알희석액,24h후진행내이3D-FLAlR MRI소묘,병대검사결과진행총결、분석,동시여전정유발적기원성전위(VEMP)급감유실험결과진행비교.결과 자공진성상현시조영제구분포도내이외림파간극,사외림파액현영증강,종이구분출내、외림파간극.대매니애병환자내이막미로적수현시적양성솔위96.1％(49/51),여VEMP급감유시험적양성솔상비차이유통계학의의(P＜0.05).51례환자수방미견고막천공、감염등병발증.결론 경고실구주사내이성상기술재매니애병환자막미로적수중구유교고적양성솔,수위유창성검사단불량반응교소,대우매니애병구유중요적진단개치화림상의의.
Objective To explore the positive visualization rate of endolymph space in Meniere's disease(MD)by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging(3D-FLAIR MRI)and assess its diagnostic value of MD.Methods 3D-FLAIR MRI was performed at 24 h after an intratympanic injection of gadolinium diethylenetriamine penta-acetic acid in 51 MD patients.Then the examination results were summarized,analyzed and compared with those of vestibular evoked myogenic potential(VEMP)and glycerol tests.Results Gadolinium was found in perilymph inside inner ear.Furthermore the border between perilymph and endolymph was visible so that endolymphatic space was distinctly visualized on 3D-FLAIR MRI.Forty-nine(96.1％)patients demonstrated the signs of endolymphatic hydrops.Statistically significant differences existed between the results of 3D-FLAIR MRI and those of VEMP and glycerol tests(P ＜ 0.05).No complication of tympanic membrane perforation or infection was observed.Conclusion After an intratympanic injection of gadolinium,3D-FLAIR MRI has a higher positive rate in MD patients.Though as an invasive procedure,it has fewer side effects and will become an important diagnostic tool for MD.