Department of Radiology, Nagoya University Graduate School of Medicine.
Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine.
Magn Reson Med Sci. 2022 Jul 1;21(3):459-467. doi: 10.2463/mrms.mp.2021-0010. Epub 2021 Apr 24.
To evaluate the relationship between the size of the venous structures related to the inner ear and the degree of endolymphatic hydrops (EH).
Thirty-four patients with a suspicion of EH underwent whole brain MR imaging including the inner ear. Images were obtained pre- and post-administration, and at 4 and 24 hours after the intravenous administration of a gadolinium-based contrast agent (IV-GBCA). The cross-sectional areas (CSA) of the internal jugular vein (IJV), superior petrosal sinus (SPS), and inferior petrosal sinus (IPS) were measured on the magnetization prepared rapid acquisition of gradient echo (MPRAGE) images obtained immediately after the IV-GBCA. The grade of EH was determined on the hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) images obtained at 4 hours after IV-GBCA as no, mild, and significant EH according to the previously proposed grading system for the cochlea and vestibule, respectively. The ipsilateral CSA was compared between groups with each level of EH grade. P < 0.05 was considered statistically significant.
There were no statistically significant differences between EH grades for the CSA of the IJV or that of the IPS in either the cochlea or the vestibule. The CSA of the SPS in the groups with significant EH was significantly smaller than that in the group with no EH, for both the cochlea (P < 0.01) and the vestibule (P < 0.05). In an ROC analysis to predict significant EH, the cut-off CSA value in the SPS was 3.905 mm for the cochlea (AUC: 0.8762, 95% confidence interval [CI]: 0.7952‒0.9572) and 3.805 mm for the vestibule (AUC: 0.7727, 95% CI: 0.6539‒0.8916).
In the ears with significant EH in the cochlea or vestibule, the CSA of the ipsilateral SPS was smaller than in the ears without EH.
评估与内耳相关的静脉结构大小与内淋巴积水（EH）程度之间的关系。
34 例疑似 EH 的患者接受了包括内耳在内的全脑 MR 成像。在静脉内给予钆基对比剂（IV-GBCA）前、后以及给药后 4 小时和 24 小时采集图像。在 IV-GBCA 后立即获得的磁化准备快速获取梯度回波（MPRAGE）图像上测量颈内静脉（IJV）、岩上窦（SPS）和岩下窦（IPS）的横截面积（CSA）。根据先前提出的耳蜗和前庭分级系统，在 IV-GBCA 后 4 小时获得的反转内淋巴信号和原始外淋巴信号的混合图像（HYDROPS）上确定 EH 程度的等级为无、轻度和显著 EH。比较每组中每个 EH 等级的同侧 CSA。P < 0.05 被认为具有统计学意义。
EH 等级在耳蜗或前庭的 IJV 或 IPS 的 CSA 之间没有统计学差异。在有显著 EH 的组中，SPS 的 CSA 在耳蜗（P < 0.01）和前庭（P < 0.05）均显著小于无 EH 组。在预测显著 EH 的 ROC 分析中，SPS 的 CSA 截断值在耳蜗为 3.905mm（AUC：0.8762，95%置信区间[CI]：0.7952-0.9572），在前庭为 3.805mm（AUC：0.7727，95%CI：0.6539-0.8916）。
在耳蜗或前庭有显著 EH 的耳朵中，同侧 SPS 的 CSA 小于无 EH 的耳朵。
