CAJ | 학술논문

目的：针对拟诊为梅尼埃病的患者，以MRI检测内淋巴积水为方法，探讨在梅尼埃病诊断中以此方法确诊为内淋巴积水的可行性，并评估临床诊断价值，分析影响判定结果的相关因素。方法选择2013.6月-2014.11月间住院病人梅尼埃病43例做为研究对象，经鼓室注射钆喷酸葡胺造影剂24小时后进行内耳MRI检查，MRI扫描序列为T1加权三维自旋回波序列(3D-FSE-T1WI),所得图像以前庭和耳蜗底转各自内淋巴面积占内外淋巴面积之和的比率大于1/3为阳性，应用三分法进行定性判定，进行计数并统计。结果在43例梅尼埃病中，35例（81.40%）在前庭发现内淋巴积水，4例（9.30%）未发现积水，另外4例（9.30%）不能确定；在耳蜗，36例（83.72%）发现内淋巴积水，3例（6.98%）未发现积水，另外4例（9.30%）不能确定。结论鼓室内注射顺磁性造影剂后内耳MRI检查可发现内淋巴积水，是临床确定内淋巴积水有效和可行的方法。其主要影响因素包括造影剂进入内耳受阻扩散不良、鼓室给药技术、MRI检测技术及主观判定因素。
목적：침대의진위매니애병적환자，이MRI검측내림파적수위방법，탐토재매니애병진단중이차방법학진위내림파적수적가행성，병평고림상진단개치，분석영향판정결과적상관인소。방법선택2013.6월-2014.11월간주원병인매니애병43례주위연구대상，경고실주사구분산포알조영제24소시후진행내이MRI검사，MRI소묘서렬위T1가권삼유자선회파서렬(3D-FSE-T1WI),소득도상이전정화이와저전각자내림파면적점내외림파면적지화적비솔대우1/3위양성，응용삼분법진행정성판정，진행계수병통계。결과재43례매니애병중，35례（81.40%）재전정발현내림파적수，4례（9.30%）미발현적수，령외4례（9.30%）불능학정；재이와，36례（83.72%）발현내림파적수，3례（6.98%）미발현적수，령외4례（9.30%）불능학정。결론고실내주사순자성조영제후내이MRI검사가발현내림파적수，시림상학정내림파적수유효화가행적방법。기주요영향인소포괄조영제진입내이수조확산불량、고실급약기술、MRI검측기술급주관판정인소。
Objective The aim of this study was to discuss feasibility and reliability of 3T MRI in detect-ing endolymphatic hydrops (EH) in Meniere’s disease (MD). Another aim was to assess factors that might af-fect study results. Methods Forty-three patients with unilateral clinically confirmed MD were evaluated with inner ear MRI. MRI imaging was completed 24 h after intratympanic administration of gadolinium chelate. The sequence of MRI was three-dimensional fast spin-echo T1-weighted imaging (3D-FSE-T1WI). A 3-point scoring system was used in the assessment of EH. Positive results were analyzed. Results MRI signs of vestibu-lar EH were positive in 35 of the 43 patients (81.40%), negative in 4 patients (9.30%) and inclonclusive in 4 pa-tients (9.30%). MRI signs of cochlear EH were positive in 36 of the 43 patients (83.72%), negative in 3 pa-tients (6.98%) and inconclusive in 4 patients (9.30%). Conclusion After intratympanic injection of gadolinium, inner ear MRI is a practical and reliable method for detecting EH in MD. The main influencing factors include obstruction of contrast agent diffusing into the inner ear, techniques of intratympanic administration, MRI de-tection sequences and physician judgment factors.