Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, Grenoble, France.
IRMaGe, University Grenoble Alpes, F-38000, Grenoble, France.
Eur Radiol. 2018 Jul;28(7):2916-2922. doi: 10.1007/s00330-017-5260-7. Epub 2018 Mar 21.
A case-controlled imaging study demonstrated that saccular hydrops was specific to Meniere's disease (MD), but only present in a subset of patients. Here, we compared patients with definite MD, vertigo and sensorineural hearing loss (SNHL) to elucidate the relationship between saccular hydrops and extent of SNHL.
In this prospective study, we performed 3D-FLAIR sequences between 4.5 and 5.5 h after contrast media injection in patients with MD (n=20), SNHL (n=20), vertigo (n=20) and 30 healthy subjects. Two radiologists independently graded saccular hydrops. ROC analysis was performed to determine the hearing loss threshold to differentiate patients with saccular hydrops.
Saccular hydrops was found in 11 of 20 MD patients, 10 of 20 SNHL patients and in none of the vertigo patients and healthy subjects. In SNHL patients, 45 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 90 %. In MD patients, 40 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 44 %.
Our results indicate saccular hydrops as a feature of worse than moderate SNHL rather than MD itself.
• MRI helps clinicians to assess patients with isolated low-tone sensorineural hearing loss. • Saccular hydrops correlates with sensorineural hearing loss at levels above 40 dB. • Vertigo patients without sensorineural hearing loss do not have saccular hydrops. • Saccular hydrops is described in patients without clinical diagnosis of Meniere's disease.
一项病例对照的影像学研究表明，球囊积水是梅尼埃病（MD）的特异性表现，但仅存在于一部分患者中。在这里，我们比较了有明确 MD、眩晕和感音神经性听力损失（SNHL）的患者，以阐明球囊积水与 SNHL 程度的关系。
在这项前瞻性研究中，我们对 MD 患者（n=20）、SNHL 患者（n=20）、眩晕患者（n=20）和 30 名健康受试者在注射对比剂后 4.5 至 5.5 小时进行了 3D-FLAIR 序列检查。两位放射科医生独立评估球囊积水。进行 ROC 分析以确定听力损失阈值，以区分有球囊积水的患者。
在 20 例 MD 患者中有 11 例、20 例 SNHL 患者中有 10 例、20 例眩晕患者中和 30 名健康受试者中均未见球囊积水。在 SNHL 患者中，45dB 是与球囊积水有显著关联的阈值，其敏感性为 100%，特异性为 90%。在 MD 患者中，40dB 是与球囊积水有显著关联的阈值，其敏感性为 100%，特异性为 44%。
我们的结果表明，球囊积水是比中度更差的感音神经性听力损失的特征，而不是 MD 本身。
• MRI 有助于临床医生评估孤立性低频感音神经性听力损失的患者。• 球囊积水与听力损失程度在 40dB 以上相关。• 无感音神经性听力损失的眩晕患者没有球囊积水。• 有临床诊断为 MD 的患者也有球囊积水。
