Department of Neuroradiology, Lariboisière University Hospital, Assistance Publique-Hopitaux de Paris, 75010 Paris, France.
Department of Head & Neck Surgery, Lariboisière University Hospital, Assistance Publique-Hopitaux de Paris, 75010 Paris, France.
Diagn Interv Imaging. 2020 Sep;101(9):537-545. doi: 10.1016/j.diii.2020.03.009. Epub 2020 Apr 3.
The purpose of this study was to investigate the clinical features of ears with otosclerosis and their correlation with endolymphatic hydrops and blood-labyrinth barrier (BLB) impairment on 3T magnetic resonance imaging (MRI).
This was a single-center retrospective imaging study. Thirty-nine ears from 29 patients (17 men, 12 women; mean age 52±12 [SD] years; range 27-74 years) with non-operated otosclerosis were included. All patients underwent three-dimensional fluid attenuated inversion recovery (FLAIR) MRI sequences performed 4hours after the intravenous administration of a single dose of gadolinium-based contrast material. MRI examinations were analyzed by two radiologists for the presence of saccular hydrops (SH) and BLB impairment. Results of MRI examinations were compared with clinical findings, hearing levels and extent of otosclerotic lesions based on high-resolution computed tomography findings. BLB impairment was evaluated using the signal intensity ratio, ratio of intensities between the basal turn of the cochlea and the medulla.
SH was observed in 1/39 (3%) otosclerotic ears and BLB impairment in 8/39 (21%) while 8/29 patients with otosclerosis (28%) had vertigo. No significant associations were found between SH or BLB impairment on MRI, and the presence of vertigo or the degree of sensorineural hearing loss.
Clinical manifestations of otosclerosis (sensorineural hearing loss and rotatory vertigo) were not significantly associated with MRI findings such as BLB impairment and endolymphatic hydrops. SH was only observed in one patient with obstruction of the vestibular aqueduct by an otosclerotic focus.
本研究旨在探讨耳硬化症的临床特征及其与内淋巴积水和血迷路屏障（BLB）损伤的相关性，这些均通过 3T 磁共振成像（MRI）得出。
这是一项单中心回顾性影像学研究。共纳入 29 例（17 名男性，12 名女性；平均年龄 52±12[SD]岁；年龄范围 27-74 岁）非手术治疗的耳硬化症患者 39 耳。所有患者均在静脉注射单剂量钆类造影剂后 4 小时进行三维液体衰减反转恢复（FLAIR）MRI 序列检查。两名放射科医生分析 MRI 检查结果，评估是否存在球囊积水（SH）和 BLB 损伤。MRI 检查结果与临床发现、听力水平和高分辨率计算机断层扫描（HRCT）发现的耳硬化症病变程度进行比较。使用信号强度比（耳蜗底回和延髓之间的强度比）评估 BLB 损伤。
39 耳中有 1 耳（3%）观察到 SH，8 耳（21%）观察到 BLB 损伤，29 例耳硬化症患者中有 8 例（28%）出现眩晕。MRI 上的 SH 或 BLB 损伤与眩晕或感音神经性听力损失的存在之间无显著相关性。
耳硬化症的临床表现（感音神经性听力损失和旋转性眩晕）与 MRI 发现（如 BLB 损伤和内淋巴积水）无显著相关性。SH 仅在 1 例因耳硬化症病灶而导致前庭水管狭窄的患者中观察到。
