Wang Pengjun, Yu Dongzhen, Wang Hui, Ye Haibo, Qiao Ruihua, Chen Zhengnong, Wu Yaqin, Li Yuehua, Shi Haibo, Zou Jing, Yin Shankai
Department of Otorhinolaryngology - Head & Neck Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.
Department of Radiology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China.
J Magn Reson Imaging. 2020 Oct;52(4):1066-1073. doi: 10.1002/jmri.27127. Epub 2020 Mar 11.
The sensitivity of endolymphatic hydrops (EH) to the glycerol test varies in patients with Menière's disease (MD).
To explore the features of EH and its glycerol-induced dynamics in MD.
Case-control study.
Twenty patients with MD (24 affected ears) were included.
FIELD STRENGTH/SEQUENCE: 3.0T 3D-FLAIR (fluid-attenuated inversion recovery) MRI and late gadolinium enhancement.
Intratympanic gadolinium-enhanced MRI was performed in the MD-affected ears before and after the glycerol test. The borders of the endolymphatic and total lymphatic space were contoured on the axial MRI slices to evaluate the volume of hydrops in both the cochlear and vestibular regions.
Paired and unpaired t-tests, the Mann-Whitney U-test, linear discriminant analysis, Pearson's correlation, and linear regression.
After glycerol ingestion, vestibular EH decreased in all patients, whereas cochlear EH significantly decreased only in patients with positive glycerol test results (all P < 0.01). At baseline, cochlear EH in the positive result group was greater than in the negative result group (P = 0.007). Unexpectedly, in the positive result group a drastic glycerol-induced dehydrating effect was observed in patients whose pretest cochlear EH ratio was >16% (P = 0.011). Moreover, the dehydrating role of glycerol was positively correlated with the baseline cochlear hydrops level (r = 0.7691, P < 0.001).
MRI provides evidence that glycerol administration improves the hearing threshold via dehydrating the EH. In the cochlear region, the baseline level of cochlear EH is a closely related factor for the validity of the glycerol test, whereas EH is consistently dehydrated in the vestibular component.
2 TECHNICAL EFFICACY STAGE: 3 J. Magn. Reson. Imaging 2020;52:1066-1073.
梅尼埃病（MD）患者内淋巴积水（EH）对甘油试验的敏感性存在差异。
探讨MD患者中EH的特征及其甘油诱导的动态变化。
病例对照研究。
纳入20例MD患者（24只患耳）。
场强/序列：3.0T三维液体衰减反转恢复（3D-FLAIR）磁共振成像（MRI）及钆剂延迟强化。
在甘油试验前后，对MD患耳进行鼓室内钆剂增强MRI检查。在轴向MRI切片上勾勒出内淋巴和总淋巴间隙的边界，以评估耳蜗和前庭区域的积水体积。
配对和非配对t检验、曼-惠特尼U检验、线性判别分析、皮尔逊相关性分析和线性回归分析。
摄入甘油后，所有患者的前庭EH均降低，而仅甘油试验结果为阳性的患者耳蜗EH显著降低（所有P<0.01）。基线时，阳性结果组的耳蜗EH大于阴性结果组（P = 0.007）。出乎意料的是，在阳性结果组中，试验前耳蜗EH比率>16%的患者观察到甘油诱导的剧烈脱水效应（P = 0.011）。此外，甘油的脱水作用与基线耳蜗积水水平呈正相关（r = 0.7691，P<0.001）。
MRI提供证据表明，甘油给药通过使EH脱水来改善听力阈值。在耳蜗区域中，耳蜗EH的基线水平是甘油试验有效性的密切相关因素，而在前庭部分EH持续脱水。
2级 技术效能阶段：3级 《磁共振成像杂志》2（2020年；52:1066 - 1073）
