Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Acta Otolaryngol. 2021 Aug;141(8):736-741. doi: 10.1080/00016489.2021.1957500. Epub 2021 Aug 4.
Otological diseases including Meniere's disease (MD) involve endolymphatic hydrops (EH), which can be visualized by magnetic resonance imaging (MRI) with gadolinium contrast agents, but the temporal changes of contrast in the inner ear have not been evaluated.
We investigated the permeability of the blood-perilymph barrier (BPB) in ears with EH to evaluate the severity of the inner ear disturbances.
The study included 32 ears from 16 patients with EH or related diseases who underwent MRI. The permeability of the BPB was assessed by the signal-intensity ratio (SIR) at four-time points: before and at 10 min, 4 h, and 24 h after administration of gadolinium for assessing EH.
Cochlear EH was found in 25 of the 32 ears, and vestibular EH in 11. The rate of EH was significantly higher in symptomatic ears; however, the existence of EH was not related to SIR values. Nevertheless, SIR values in the basal turn were significantly higher 4 and 24 h after injection of gadolinium in patients aged ≥50 years.
Higher SIR values observed in older patients with EH indicate severe disturbances of the BPB in the cochlea, which may account for intractable inner ear disturbances in older patients.
耳科学疾病包括梅尼埃病（MD），涉及内淋巴积水（EH），可以通过磁共振成像（MRI）和钆造影剂来可视化，但内耳内对比剂的时间变化尚未得到评估。
我们研究了 EH 中耳的血迷路屏障（BPB）通透性，以评估内耳障碍的严重程度。
该研究纳入了 16 例 EH 或相关疾病患者的 32 只耳朵，这些患者均接受了 MRI 检查。BPB 的通透性通过四个时间点的信号强度比（SIR）来评估：在给予钆前后的 10 分钟、4 小时和 24 小时评估 EH。
32 只耳朵中有 25 只发现耳蜗 EH，11 只发现前庭 EH。症状性耳中 EH 的发生率明显更高；然而，EH 的存在与 SIR 值无关。然而，在≥50 岁的患者中，注射钆后 4 小时和 24 小时，基底回的 SIR 值明显更高。
EH 老年患者中观察到的更高 SIR 值表明 BPB 在耳蜗中严重受损，这可能是老年患者内耳难以治疗的原因。
