Department of neuroradiology and MRI, Grenoble Alpes university hospital-SFR RMN neurosciences, 38000 Grenoble, France; University Grenoble Alpes, IRMaGe, 38000 Grenoble, France.
Department of neuroradiology and MRI, Grenoble Alpes university hospital-SFR RMN neurosciences, 38000 Grenoble, France; Department of Radiology, Rouen university hospital, 76000 Rouen, France.
Diagn Interv Imaging. 2017 Oct;98(10):699-706. doi: 10.1016/j.diii.2017.06.002. Epub 2017 Jun 20.
The goal of this retrospective study was to investigate the differential diagnosis of endolymphatic hydrops in patients with Meniere's disease (MD) symptoms by using magnetic resonance imaging (MRI) with intravenous injection of gadolinium chelate and delayed acquisition.
Two hundred patients (133 women, 67 men; mean age=67.2±11 ([SD] years) with unilateral MD underwent MRI at 3-T, between 4.5 and 5.5hours after intravenous administration of gadoterate meglumine at a dose of 0.1mmol/kg. MR images were analyzed for the presence of saccular hydrops, perilymphatic fistulae, inner ear malformations, semicircular canal (SCC) abnormal enhancement and brain lesions. We also tested the potential relationship between past history of gentamicin intratympanic administration and perilymphatic fistula presence and SCC aspect.
Saccular hydrops were found in 96/200 patients with MD (48%). Three patients (1.5%) had perilymphatic fistulas associated with saccular hydrops, as confirmed by surgery. There was a correlation between the presence of perilymphatic fistula and past history of intratympanic gentamicin administration (P=0.02). We detected inner ear malformations in 5 patients (2.5%), SCC local enhancement in 15 patients (7.5%) always on the same side than the clinical symptoms of MD. There was a correlation between the presence of SCC abnormal enhancement and past intratympanic gentamicin administration (P=0.001). Five patients (2.5%) had brain lesions along central cochleovestibular pathways.
MRI may reveal brain lesions, SCC abnormalities and perilymphatic fistulae in patients with clinical MD.
本回顾性研究的目的是通过静脉注射钆螯合物后延迟采集磁共振成像（MRI）来探讨梅尼埃病（MD）患者内淋巴积水的鉴别诊断。
200 名单侧 MD 患者（133 名女性，67 名男性；平均年龄=67.2±11 岁）在静脉注射 0.1mmol/kg 剂量的钆特酸葡甲胺后 4.5-5.5 小时内行 3-T MRI 检查。分析 MRI 图像以评估是否存在球囊积水、迷路瘘管、内耳畸形、半规管（SCC）异常增强和脑病变。我们还测试了既往鼓室内庆大霉素给药史与迷路瘘管存在和 SCC 方面的潜在关系。
96/200 名 MD 患者（48%）存在球囊积水。3 名患者（1.5%）存在与球囊积水相关的迷路瘘管，通过手术得到证实。迷路瘘管的存在与既往鼓室内庆大霉素给药史相关（P=0.02）。5 名患者（2.5%）存在内耳畸形，15 名患者（7.5%）存在 SCC 局部增强，且总是与 MD 的临床症状同侧。SCC 异常增强的存在与既往鼓室内庆大霉素给药史相关（P=0.001）。5 名患者（2.5%）存在中枢耳蜗前庭径路的脑病变。
MRI 可发现有临床 MD 表现的患者存在脑病变、SCC 异常和迷路瘘管。
