Hagiwara Mari, Roland J Thomas, Wu Xin, Nusbaum Annette, Babb James S, Roehm Pamela C, Hammerschlag Paul, Lalwani Anil K, Fatterpekar Girish
*Departments of Radiology and †Otolaryngology, New York University School of Medicine, New York, New York, U.S.A.; ‡Department of Otolaryngology, Temple University, Philadelphia, Pennsylvania, and §Department of Otolaryngology, Columbia University, New York, New York, U.S.A.
Otol Neurotol. 2014 Dec;35(10):e337-42. doi: 10.1097/MAO.0000000000000585.
The preferential delayed enhancement of the perilymphatic space enables detection of the non-enhancing endolymphatic hydrops present in patients with Ménière's disease. The aim of this study was to evaluate the diagnostic utility of delayed postcontrast 3D FLAIR images and a color map of fused postcontrast FLAIR and constructive interference steady state (CISS) images in the identification of endolymphatic hydrops in patients with clinically diagnosed Ménière's disease.
Case control, blinded study.
Tertiary referral center.
Ten patients with Ménière's disease and five volunteer controls.
Diagnostic.
Two neuroradiologists blinded to the clinical history independently evaluated for the presence of endolymphatic hydrops on the images of both inner ears for test and control subjects. Both the standard gray-scale FLAIR images and the fused color map images were independently reviewed.
The gray-scale 3D FLAIR images demonstrated 68.2% sensitivity and 97.4% specificity, and the fused color map images demonstrated 85.0% sensitivity and 88.9% specificity in the identification of endolymphatic hydrops in Ménière's disease. There was significant correlation between the gray-scale 3D FLAIR images and fused color map images with the categorization of involvement (p = 0.002). Inter-evaluator reliability was excellent (kappa = 0.83 for gray-scale images, kappa = 0.81 for fused color map).
Delayed 3D FLAIR and fused 3D FLAIR-CISS color map images of the inner ears after intravenous contrast administration are potentially useful diagnostic tools in the evaluation of patients with suspected Ménière's disease.
内淋巴间隙的延迟强化有助于检测梅尼埃病患者中存在的无强化的内淋巴积水。本研究的目的是评估延迟增强后三维液体衰减反转恢复（FLAIR）图像以及融合的增强后FLAIR与相干梯度回波稳态进动（CISS）图像的彩色图谱在临床诊断为梅尼埃病患者内淋巴积水识别中的诊断效用。
病例对照、盲法研究。
三级转诊中心。
10例梅尼埃病患者和5名志愿者对照。
诊断性。
两名对临床病史不知情的神经放射科医生独立评估测试组和对照组受试者双耳图像上内淋巴积水的存在情况。标准灰度FLAIR图像和融合彩色图谱图像均进行独立评估。
灰度三维FLAIR图像在梅尼埃病内淋巴积水识别中的敏感性为68.2%，特异性为97.4%；融合彩色图谱图像的敏感性为85.0%，特异性为88.9%。灰度三维FLAIR图像与融合彩色图谱图像在受累程度分类方面存在显著相关性（p = 0.002）。评估者间可靠性良好（灰度图像的kappa值为0.83，融合彩色图谱的kappa值为0.81）。
静脉注射造影剂后内耳的延迟三维FLAIR图像和融合的三维FLAIR-CISS彩色图谱图像是评估疑似梅尼埃病患者潜在有用的诊断工具。
