Yoshida Tadao, Sugimoto Satofumi, Teranishi Masaaki, Otake Hironao, Yamazaki Masahiro, Naganawa Shinji, Nakashima Tsutomu, Sone Michihiko
Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Auris Nasus Larynx. 2018 Feb;45(1):33-38. doi: 10.1016/j.anl.2017.02.002. Epub 2017 Feb 28.
To examine endolymphatic hydrops (EH) using magnetic resonance imaging (MRI) in patients with definite Ménière's disease (MD) and those with nonotological diseases.
We studied 32 patients with unilateral MD, 10 patients with bilateral MD and 21 patients with control ears who had other benign diseases not associated with hearing or vestibular dysfunction. The mean age of the subjects was 54.0 years (range 27-74) in the MD group and 56.1 years (range 24-79) in the control group. Using MRI, the degree of EH was classified as none, mild and significant in the cochlea and vestibule separately. The ratio of the area of endolymphatic space to the vestibular fluid space was calculated for the vestibule. The duration of MD was defined as the months between the first attack of MD and the MRI study.
EH was present in the cochlea of 45/52 affected ears of patients with MD (87%) and in 16/42 control ears (38%). Significant cochlear hydrops was present in 37/52 affected ears (71%) and in 4/42 control ears (10%). EH in the vestibule was present in 49/52 affected ears (94%) and in 3/42 control ears (7%). Significant vestibular hydrops was present in 40/52 affected ears (77%) and in none of the 42 control ears. There was no relationship between the degree of EH and its duration. Using a cut off value for the relative size of EH in the vestibule of 41.9%, the test had a sensitivity of 88.5% and a specificity of 100% to diagnose definite MD.
Cochlear EH was occasionally observed in control ears on MRI, as in normal temporal bone specimens. The presence or absence and degree of vestibular EH were significantly different between ears with MD and control ears. EH in the vestibule might be a specific predictor of definite MD.
使用磁共振成像（MRI）检查确诊梅尼埃病（MD）患者及非耳科疾病患者的内淋巴积水（EH）情况。
我们研究了32例单侧MD患者、10例双侧MD患者以及21例对照耳患者，这些对照耳患者患有与听力或前庭功能障碍无关的其他良性疾病。MD组受试者的平均年龄为54.0岁（范围27 - 74岁），对照组为56.1岁（范围24 - 79岁）。通过MRI，将耳蜗和前庭内EH的程度分别分为无、轻度和重度。计算前庭内淋巴间隙面积与前庭液间隙面积的比值。MD的病程定义为MD首次发作至MRI检查之间的月数。
MD患者52只患耳中的45只（87%）耳蜗存在EH，42只对照耳中的16只（38%）存在EH。52只患耳中的37只（71%）存在重度耳蜗积水，42只对照耳中的4只（10%）存在重度耳蜗积水。前庭EH存在于52只患耳中的49只（94%），42只对照耳中的3只（7%）。40只患耳（77%）存在重度前庭积水，42只对照耳均无重度前庭积水。EH程度与其病程之间无相关性。以前庭EH相对大小的截断值41.9%进行检测，诊断确诊MD的敏感性为88.5%，特异性为100%。
如同在正常颞骨标本中一样，MRI偶尔在对照耳中观察到耳蜗EH。MD患耳与对照耳在前庭EH的有无及程度上存在显著差异。前庭EH可能是确诊MD的特异性预测指标。
