Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Eur Arch Otorhinolaryngol. 2022 May;279(5):2279-2290. doi: 10.1007/s00405-021-06912-4. Epub 2021 Jun 18.
It is still challenging to detect endolymphatic hydrops (EH) in patients with Meniere's disease (MD) using MRI. The aim of the present study was to optimize a sensitive technique generating strong contrast enhancement from minimum gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) while reliably detecting EH in the inner ear, including the apex.
All imaging was performed using a 3.0 T MR system 24 h after intratympanic injection of low-dose Gd-DTPA. Heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed with magnitude and zero-filled interpolation (hTW-FLAIR-ZFI) was optimized and validated in phantom studies and compared with medium inversion time inversion recovery imaging with magnitude reconstruction (MIIRMR). The following parameters were used in hTW-FLAIR-ZFI: repetition time 14,000 ms, echo time 663 ms, inversion time 2900 ms, flip angle 120°, echo train length 271, and field of view 166 × 196 mm.
MRI obtained using hTW-FLAIR-MZFI yielded high-quality images with sharper and smoother borders between the endolymph and perilymph and a higher signal intensity ratio and more homogenous perilymph enhancement than those generated with MIIRMR (p < 0.01). There were predominantly grade II EHs in the cochleae and grade III EHs in the vestibule in definite MD. EH was detected in the apex of 11/16 ipsilateral ears, 3/16 contralateral ears in unilateral definite MD and 3/6 ears in bilateral MD.
The novel hTW-FLAIR-MZFI technique is sensitive and demonstrates strong and homogenous enhancement by minimum Gd-DTPA in the inner ear, including the apex, and yields high-quality images with sharp borders between the endolymph and perilymph.
使用 MRI 检测梅尼埃病（MD）患者的内淋巴积水（EH）仍然具有挑战性。本研究旨在优化一种敏感技术，在最小的钆二乙烯五胺五乙酸（Gd-DTPA）浓度下产生强烈的对比增强，同时可靠地检测内耳，包括顶点的 EH。
所有成像均在经鼓室内注射低剂量 Gd-DTPA 后 24 小时内在 3.0T MR 系统上进行。使用重 T2 加权 3 维液体衰减反转恢复重建（hTW-FLAIR-ZFI），在体模研究中进行优化和验证，并与具有幅度重建的中反转时间反转恢复成像（MIIRMR）进行比较。hTW-FLAIR-ZFI 采用以下参数：重复时间 14,000ms，回波时间 663ms，反转时间 2900ms，翻转角 120°，回波链长度 271，视野 166×196mm。
使用 hTW-FLAIR-MZFI 获得的 MRI 图像质量高，内淋巴和外淋巴之间的边界更清晰、更平滑，信号强度比更高，外淋巴增强更均匀，优于 MIIRMR（p<0.01）。在明确的 MD 中，耳蜗主要为 II 级 EH，前庭为 III 级 EH。在单侧明确 MD 的 11/16 侧耳的顶点、3/16 对侧耳中检测到 EH，在双侧 MD 的 3/6 耳中检测到 EH。
新型 hTW-FLAIR-MZFI 技术具有敏感性，可在最小 Gd-DTPA 浓度下对内耳，包括顶点，进行强烈且均匀的增强，并产生高清晰度的图像，内淋巴和外淋巴之间的边界清晰。
