Naganawa Shinji, Suzuki Kojiro, Yamazaki Masahiro, Sakurai Yasuo, Ikeda Mitsuru
Department of Radiology, Nagoya University Graduate School of Medicine.
Magn Reson Med Sci. 2014;13(2):73-80. doi: 10.2463/mrms.2013-0080. Epub 2014 Apr 28.
We developed semi-quantitative methods to measure endolymphatic size on images obtained 4 hours after intravenous administration of single-dose gadolinium-based contrast medium (IV-SD-GBCM) and found little variation in results between observers. We used the methods to measure the size of the endolymph in healthy volunteers at various times after IV-SD-GBCM and attempted to determine the optimal timing for the evaluation.
In 8 healthy male volunteers, we obtained heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery (hT2W-3D-FLAIR) images 1.5, 3, 4.5, and 6 hours after IV-SD-GBCM as positive perilymph images (PPI) as well as acquiring positive endolymph images (PEI) and magnetic resonance cisternography (MRC). To evaluate the endolymph, we generated 2 kinds of processed images (HYDROPS-Mi2 and HYDROPS2-Mi2) by subtracting PEI or MRC from PPI as previously proposed. We semi-quantitatively measured the ratio of the area of the endolymph (%EL) to that of total lymph on the 2 kinds of generated images for the cochlea and vestibule according to the previously proposed method. We analyzed statistics to evaluate the change in %EL over time and used analysis of variance (ANOVA) for a 2 × 4 repeated-measures design to assess difference in image type. We adopted 5% as a significance level.
The %EL was significantly larger at 1.5 hours after IV-SD-GBCM than at 3, 4.5, and 6 hours in both the cochlea and vestibule for both kinds of generated images. Between 4.5 and 6 hours, the %EL plateaued for both the cochlea and vestibule, and the 2 kinds of generated images did not differ significantly.
A delay of 1.5 hours after IV-SD-GBCM is not sufficient to evaluate endolymphatic size. The %EL plateaus between 4.5 and 6 hours. These data might be valuable for further clinical studies.
我们开发了半定量方法,用于在静脉注射单剂量钆基造影剂(IV-SD-GBCM)4小时后所获得的图像上测量内淋巴的大小,并发现观察者之间的结果差异很小。我们使用这些方法在IV-SD-GBCM后的不同时间测量健康志愿者内淋巴的大小,并试图确定评估的最佳时机。
在8名健康男性志愿者中,我们在IV-SD-GBCM后1.5、3、4.5和6小时获取了重度T2加权三维液体衰减反转恢复(hT2W-3D-FLAIR)图像作为阳性外淋巴图像(PPI),同时获取阳性内淋巴图像(PEI)和磁共振脑池造影(MRC)。为了评估内淋巴,我们按照先前提出的方法,通过从PPI中减去PEI或MRC生成了2种处理后的图像(HYDROPS-Mi2和HYDROPS2-Mi2)。我们根据先前提出的方法,在生成图像上半定量测量耳蜗和前庭内淋巴面积(%EL)与总淋巴面积的比值。我们进行统计分析以评估%EL随时间的变化,并使用2×4重复测量设计的方差分析(ANOVA)来评估图像类型的差异。我们采用5%作为显著性水平。
对于两种生成图像,在IV-SD-GBCM后1.5小时,耳蜗和前庭的%EL均显著大于3、4.5和6小时时的%EL。在4.5至6小时之间,耳蜗和前庭的%EL均趋于平稳,且两种生成图像之间无显著差异。
IV-SD-GBCM后延迟1.5小时不足以评估内淋巴大小。%EL在4.5至6小时之间趋于平稳。这些数据可能对进一步的临床研究有价值。