Gürkov R, Berman A, Dietrich O, Flatz W, Jerin C, Krause E, Keeser D, Ertl-Wagner B
Department of Otorhinolaryngology Head and Neck Surgery, Grosshadern Medical Centre, University of Munich, Marchioninistr. 15, 81377, Munich, Germany,
Eur Radiol. 2015 Feb;25(2):585-95. doi: 10.1007/s00330-014-3414-4. Epub 2014 Oct 16.
We aimed to volumetrically quantify endolymph and perilymph spaces of the inner ear in order to establish a methodological basis for further investigations into the pathophysiology and therapeutic monitoring of Menière's disease.
Sixteen patients (eight females, aged 38-71 years) with definite unilateral Menière's disease were included in this study. Magnetic resonance (MR) cisternography with a T2-SPACE sequence was combined with a Real reconstruction inversion recovery (Real-IR) sequence for delineation of inner ear fluid spaces. Machine learning and automated local thresholding segmentation algorithms were applied for three-dimensional (3D) reconstruction and volumetric quantification of endolymphatic hydrops. Test-retest reliability was assessed by the intra-class coefficient; correlation of cochlear endolymph volume ratio with hearing function was assessed by the Pearson correlation coefficient.
Endolymph volume ratios could be reliably measured in all patients, with a mean (range) value of 15% (2-25) for the cochlea and 28% (12-40) for the vestibulum. Test-retest reliability was excellent, with an intra-class coefficient of 0.99. Cochlear endolymphatic hydrops was significantly correlated with hearing loss (r = 0.747, p = 0.001).
MR imaging after local contrast application and image processing, including machine learning and automated local thresholding, enable the volumetric quantification of endolymphatic hydrops. This allows for a quantitative assessment of the effect of therapeutic interventions on endolymphatic hydrops.
• Endolymphatic hydrops is the pathological hallmark of Menière's disease. • Endolymphatic hydrops can be visualized by locally enhanced ultra-high-resolution MR imaging. • Computer-aided image processing enables quantification of endolymphatic hydrops. • Endolymphatic hydrops correlates with hearing loss in patients with Menière's disease. • Therapeutic trials in Menière's disease can be monitored with this quantitative approach.
我们旨在对内耳的内淋巴和外淋巴间隙进行容积定量分析，以便为进一步研究梅尼埃病的病理生理学和治疗监测奠定方法学基础。
本研究纳入了16例确诊为单侧梅尼埃病的患者（8名女性，年龄38 - 71岁）。采用T2-SPACE序列的磁共振（MR）脑池造影结合真实重建反转恢复（Real-IR）序列来描绘内耳液腔。应用机器学习和自动局部阈值分割算法对内淋巴积水进行三维（3D）重建和容积定量分析。通过组内相关系数评估重测信度；采用Pearson相关系数评估耳蜗内淋巴体积比与听力功能的相关性。
所有患者的内淋巴体积比均可可靠测量，耳蜗的平均（范围）值为15%（2% - 25%），前庭为28%（12% - 40%）。重测信度极佳，组内相关系数为0.99。耳蜗内淋巴积水与听力损失显著相关（r = 0.747，p = 0.001）。
局部造影剂应用后的MR成像及包括机器学习和自动局部阈值处理在内的图像处理，能够对内淋巴积水进行容积定量分析。这使得对治疗干预对内淋巴积水的效果进行定量评估成为可能。
• 内淋巴积水是梅尼埃病的病理标志。• 通过局部增强的超高分辨率MR成像可观察到内淋巴积水。• 计算机辅助图像处理能够对内淋巴积水进行定量分析。• 梅尼埃病患者的内淋巴积水与听力损失相关。• 可用这种定量方法监测梅尼埃病的治疗试验。
