Sugiura M, Naganawa S, Sato E, Nakashima T
Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Laryngol Otol. 2006 Dec;120(12):1084-6. doi: 10.1017/S0022215106003331. Epub 2006 Sep 25.
To evaluate the inner ear of a patient with an enlarged vestibular aqueduct and acute hearing deterioration, using three-dimensional fluid-attenuated inversion recovery (3D FLAIR) magnetic resonance imaging (MRI).
Three-dimensional fluid-attenuated inversion recovery MRI has been recently developed to detect haemorrhage and high concentrations of protein. Application of this method to inner-ear diseases has not been fully described.
We used 3D FLAIR MRI to evaluate a patient with an enlarged vestibular aqueduct and acute hearing deterioration.
On 3D FLAIR MRI, this patient had high signals in the endolymphatic duct and sac, the vestibule and the cochlea and was diagnosed as having a high protein concentration in the inner ear. These high signal areas were not detected by T1- and T2-weighted MRI.
This is the first published case in which a high protein concentration in the cochlea of a patient with an enlarged vestibular aqueduct was detected by 3D FLAIR MRI. These findings strongly supported the theory of the pathophysiology of hearing deterioration in patients with an enlarged vestibular aqueduct, which states that hyperosmolar fluid in the enlarged endolymphatic sac refluxes into the cochlea, resulting in damage to the hair cells. Thus, these finding may help clarify the cause of hearing deterioration in the presence of a large endolymphatic duct and sac.
使用三维液体衰减反转恢复（3D FLAIR）磁共振成像（MRI）评估一名患有扩大的前庭导水管且听力急性减退患者的内耳情况。
三维液体衰减反转恢复MRI最近已被开发用于检测出血和高浓度蛋白质。该方法在内耳疾病中的应用尚未得到充分描述。
我们使用3D FLAIR MRI评估一名患有扩大的前庭导水管且听力急性减退的患者。
在3D FLAIR MRI上，该患者的内淋巴管和内淋巴囊、前庭和耳蜗出现高信号，被诊断为内耳蛋白质浓度高。T1加权和T2加权MRI未检测到这些高信号区域。
这是首次发表的通过3D FLAIR MRI检测到扩大的前庭导水管患者耳蜗中蛋白质浓度高的病例。这些发现有力地支持了扩大的前庭导水管患者听力减退的病理生理学理论，即扩大的内淋巴囊中的高渗液反流至耳蜗，导致毛细胞受损。因此，这些发现可能有助于阐明存在大的内淋巴管和内淋巴囊时听力减退的原因。
