Zhu Honglei, Ou Yongkang, Fu Jia, Zhang Ya, Xiong Hao, Xu Yaodong
Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Eur Arch Otorhinolaryngol. 2015 Oct;272(10):2659-65. doi: 10.1007/s00405-014-3187-z. Epub 2014 Aug 6.
It has been reported that about half of patients with sudden sensorineural hearing loss (SSNHL) show high signals in the affected inner ear on three-dimensional, fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI). These signals may reflect minor hemorrhage or an increased concentration of protein in the inner ear, which has passed through blood vessels with increased permeability. Our objective was to compare the positive ratio of the high signal in affected inner ears at different time points to determine the suitable imaging time point for 3D-FLAIR MRI in SSNHL. 3D-FLAIR MRI images were taken at three times, precontrast and approximately 10 min and 4 h after intravenous injection of a single dose of gadodiamide (Gd) (0.1 mmol/kg), in 46 patients with SNHL. We compared the positive findings of the high signals in the inner ear of patients with SNHL as well as the signal intensity ratio (SIR) between the affected cochleae and unaffected cochleae at three time points. The positive ratios of the high signals in the affected inner ear at the time points of precontrast and 10 min and 4 h after the intravenous Gd injection were 26.1, 32.6, and 41.3%, respectively. The high signal intensity ratios of affected inner ears at the three time points were 1.28, 1.31, and 1.48, respectively. The difference between the positive ratios precontrast and at 10 min after the intravenous Gd injection was statistically significant (P = 0.006); the differences between the positive ratios at 4 h after the intravenous Gd injection and precontrast and between the ratios at 4 h and 10 min after the intravenous Gd injection were not statistically significant. The time effects of the median value of SIR were not significant (P = 0.064). We do not recommend 4 h after intravenous Gd injection as a time point to image the inner ear in SNHL. We believe that imaging precontrast and at 10 min after the intravenous Gd injection are suitable time points.
据报道，约一半的突发性感音神经性听力损失（SSNHL）患者在三维液体衰减反转恢复磁共振成像（3D-FLAIR MRI）上受影响的内耳显示高信号。这些信号可能反映内耳的轻微出血或蛋白质浓度增加，这是通过通透性增加的血管进入内耳的。我们的目的是比较不同时间点受影响内耳高信号的阳性率，以确定SSNHL中3D-FLAIR MRI的合适成像时间点。对46例感音神经性听力损失（SNHL）患者在静脉注射单剂量钆双胺（Gd）（0.1 mmol/kg）前、注射后约10分钟和4小时三个时间点进行3D-FLAIR MRI成像。我们比较了SNHL患者内耳高信号的阳性结果以及三个时间点患侧耳蜗与未患侧耳蜗之间的信号强度比（SIR）。静脉注射Gd前、注射后10分钟和4小时时，患侧内耳高信号的阳性率分别为26.1%、32.6%和41.3%。三个时间点患侧内耳的高信号强度比分别为1.28、1.31和1.48。静脉注射Gd前与注射后10分钟时阳性率的差异具有统计学意义（P = 0.006）；静脉注射Gd后4小时与注射前阳性率的差异以及静脉注射Gd后4小时与10分钟阳性率的差异均无统计学意义。SIR中位数的时间效应不显著（P = 0.064）。我们不建议将静脉注射Gd后4小时作为SNHL内耳成像的时间点。我们认为注射前和静脉注射Gd后10分钟是合适的成像时间点。
