Liu Yupeng, Zhang Fan, He Baihui, He Jingchun, Zhang Qing, Yang Jun, Duan Maoli
Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Front Surg. 2021 Jun 4;8:673811. doi: 10.3389/fsurg.2021.673811. eCollection 2021.
Currently, 3 Tesla-MRI following intratympanic gadolinium injection has made it possible to assess the existence and the severity of hydrops in each compartment of the endolymphatic spaces . However, the relationship between vestibular endolymphatic hydrops (EH) visualized by MRI and vestibular functional tests, especially the correlation between caloric test, video-head impulse test, and semicircular canal hydrops, has not been well-investigated. The purpose of this study is to investigate the relationship between the severity of EH in each compartment of otoliths and semicircular canal and the results of vestibular functional tests. In this retrospective study, we performed three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequences following intratympanic gadolinium injection in 69 unilateral patients with definite Menière's disease. Vestibular and lateral semicircular canal hydrops was graded on MRI using a four grade criterion. All patients underwent pure-tone audiometry, cervical vestibular evoked myogenic potential (cVEMP), ocular vestibular evoked myogenic potential (oVEMP), caloric test and video head impulse test (vHIT). The latency, amplitude and asymmetry ratio of VEMP, canal paresis (CP) and vestibulo-ocular reflex (VOR) gain of lateral semicircular canal of vHIT were collected. The correlation analysis were performed between the parameters of function test and EH. Vestibular EH showed correlations with the duration of disease ( = 0.360) and pure tone average ( = 0.326). AR of cVEMP showed correlations with Vestibular EH ( = 0.407). CP ( = 0.367) and VOR gain of lateral semicircular canal at 60 ms ( = 0.311) showed correlations with lateral semicircular canal hydrops. EH in different compartments is readily visualized by using 3D-FLAIR MRI techniques. The degree of vestibular EH correlated with AR of cVEMP and EH in the semicircular canal ampullar affects the caloric and vHIT response in patients with unilateral Meniere's disease.
目前，鼓膜内注射钆后进行3特斯拉磁共振成像（MRI），使得评估内淋巴间隙各腔室积水的存在及严重程度成为可能。然而，MRI显示的前庭内淋巴积水（EH）与前庭功能测试之间的关系，尤其是冷热试验、视频头脉冲试验与半规管积水之间的相关性，尚未得到充分研究。本研究的目的是探讨耳石和半规管各腔室EH的严重程度与前庭功能测试结果之间的关系。在这项回顾性研究中，我们对69例单侧确诊梅尼埃病患者进行了鼓膜内注射钆后的三维液体衰减反转恢复（3D-FLAIR）序列检查。MRI上使用四级标准对前庭和外侧半规管积水进行分级。所有患者均接受纯音听力测定、颈前庭诱发肌源性电位（cVEMP）、眼前庭诱发肌源性电位（oVEMP）、冷热试验和视频头脉冲试验（vHIT）。收集VEMP的潜伏期、振幅和不对称比、vHIT外侧半规管的管轻瘫（CP）和前庭眼反射（VOR）增益。对功能测试参数与EH进行相关性分析。前庭EH与病程（r = 0.360）和纯音平均值（r = 0.326）相关。cVEMP的AR与前庭EH相关（r = 0.407）。CP（r = 0.367）和60 ms时外侧半规管的VOR增益（r = 0.311）与外侧半规管积水相关。使用3D-FLAIR MRI技术可以很容易地观察到不同腔室的EH。前庭EH的程度与cVEMP的AR相关，单侧梅尼埃病患者半规管壶腹的EH影响冷热试验和vHIT反应。
