Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland; Head: Prof. Kazimierz Niemczyk MD PhD.
Department of Clinical Radiology, Medical University of Warsaw, Poland; Head: Prof. Olgierd Rowiński MD PhD.
Otolaryngol Pol. 2020 Dec 29;75(2):1-8. doi: 10.5604/01.3001.0014.6176.
Ménière's disease is characterized by sudden episodes of vertigo accompanied by tinnitus and/or feeling of fullness in the ear as well as fluctuating sensorineural hearing loss. Despite numerous studies, the etiology of this disease remains unknown. However, the enlargement of the inner ear's endolymphatic spaces, referred to as endolymphatic hydrops, is considered the underlying condition. Thanks to recent advances in magnetic resonance (MR) technology, it is now possible to obtain in vivo imaging of endolymphatic hydrops in patients presenting with Ménière's disease symptoms. Visualization of the inner ear fluid compartments is achieved after gadolinium contrast is administered into the tympanic cavity or via the intravenous route. Evaluation of endolymphatic hydrops is possible as the contrast agent selectively penetrates the perilymph, and endolymph is visualized as contrast defects. The currently used radiological hydrops grading systems include qualitative, semi-quantitative, and volumetric scales. The methods are subject to ongoing modifications to increase their sensitivity and specificity. Numerous studies describe correlations between clinical symptoms and audiological and otoneurological examination results with the endolymphatic hydrops grade. MRI is also applicable in patients' diagnostics with an incomplete or atypical course of the Ménière's disease. In the course of the treatment, follow-up MRI scans enable assessing individual treatment modalities' efficacy in terms of the severity of lesions and the further course of the disease within the inner ear.
梅尼埃病的特征是突发性眩晕，伴有耳鸣和/或耳部饱满感，以及波动性感音神经性听力损失。尽管进行了大量研究，但该病的病因仍不清楚。然而，内耳内淋巴液空间的扩大，即内淋巴积水，被认为是其潜在的发病条件。得益于磁共振（MR）技术的最新进展，现在可以对出现梅尼埃病症状的患者进行内淋巴积水的活体成像。在鼓室或通过静脉途径给予钆造影剂后，可对内耳液腔进行可视化。当造影剂选择性穿透外淋巴时，内淋巴显示为造影缺损，从而可以对内淋巴积水进行评估。目前使用的放射性积水分级系统包括定性、半定量和容积分级。这些方法正在不断修改，以提高其敏感性和特异性。许多研究描述了临床症状与听力和耳神经科检查结果与内淋巴积水分级之间的相关性。在不完全或不典型的梅尼埃病病程中，MRI 也适用于患者的诊断。在治疗过程中，随访 MRI 扫描可以评估个体治疗方法在病变严重程度和内耳疾病进一步发展方面的疗效。
