Fang Z M, Wang H X, Lai Y M, He H X, Chen X
Department of Medical Imaging, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
Department of Otolaryngology, Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, China.
Zhonghua Yi Xue Za Zhi. 2020 Dec 15;100(46):3684-3688. doi: 10.3760/cma.j.cn112137-20200909-02610.
To investigate the success rate, safety and repeatability of gadolinium (Gd)-enhanced inner ear magnetic resonance (MR) by tympanic membrane puncture. The imaging and clinical data of 1 126 cases with Gd-enhanced inner ear MR by tympanic membrane puncture from February 2010 to June 2020 were retrospectively analyzed. All cases were reexamined in the outpatient clinic after MR gadolinium contrast to check the tympanic membrane and external auditory canal. The success rate was identified by whether there was gadolinium contrast in the labyrinth. Meanwhile, the pure tone hearing threshold data of asymptomatic ears before and after gadolinium contrast was collected and compared. The consistency in the scores of the asymptomatic ears in patients who underwent twice Gd-enhanced MR was analyzed, in which the scores of vestibular, cochlea, and semicircular canals were acquired respectively. Among 1 126 patients [including 506 males and 620 females, aged (54±17) years old], 45 were reviewed once, while 4 patients were reviewed twice. There were 958 cases who were examined on both sides, and 168 cases were checked only on one side. There were 166 cases of Meniere's disease (14.7%), 219 cases of sudden sensorineural hearing loss (19.5%) and 741 cases of being remained to be investigated (65.8%), respectively. A total of 2 084 ears underwent first gadolinium angiography, of which 63 ears had no contrast agent in the labyrinth, with a success rate of 97.0% (2 021/2 084). Only 1 case had tympanic membrane perforation while the rest had no complications. The hearing threshold before and after otography in 57 asymptomatic ears had no differences at any frequency (all >0.05). Moreover, the consistency in the scores of two radiography within the 21 asymptomatic ears in vestibular and cochlea was good [both intraclass correlation coefficient (ICC) values>0.75]. The success rate and safety of Gd-enhanced inner ear MR is high by tympanic membrane puncture, and the results can be repeated well.
探讨鼓膜穿刺钆(Gd)增强内耳磁共振成像(MR)的成功率、安全性及可重复性。回顾性分析2010年2月至2020年6月期间1126例行鼓膜穿刺钆增强内耳MR检查患者的影像及临床资料。所有患者在MR钆造影后门诊复查鼓膜及外耳道情况。根据内耳是否有钆造影剂判断成功率。同时收集并比较钆造影前后无症状耳的纯音听阈数据。分析1126例患者中1126例(包括男性506例、女性620例,年龄(54±17)岁),45例复查1次,4例复查2次。双侧检查958例,单侧检查168例。分别有梅尼埃病166例(14.7%)、突发性聋219例(19.5%)、待查741例(65.8%)。共2084耳行首次钆造影,其中63耳内耳无造影剂,成功率为97.0%(2021/2084)。仅1例鼓膜穿孔,其余无并发症。57例无症状耳造影前后各频率听阈差异均无统计学意义(均P>0.05)。21例无症状耳前庭及耳蜗两次造影评分一致性良好(组内相关系数(ICC)值均>0.75)。鼓膜穿刺钆增强内耳MR成功率及安全性高,结果可重复性好。