增强磁共振成像证实的内淋巴积水性梅尼埃病患者的临床特征和影像学特征。
The clinical features and image characteristics of Meniere's disease patients with endolymphatic hydrops confirmed by enhanced magnetic resonance imaging.
机构信息
Eye & ENT Hospital of Fudan University, Department of Radiology, Shanghai, China; Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.
Eye & ENT Hospital of Fudan University, Department of Otolaryngology, Shanghai, China.
出版信息
Braz J Otorhinolaryngol. 2022 Nov-Dec;88 Suppl 3(Suppl 3):S34-S40. doi: 10.1016/j.bjorl.2021.07.009. Epub 2021 Oct 17.
OBJECTIVES
To analyze and summarize the clinical features and image characteristics of Meniere's Disease (MD) patients with Endolymphatic Hydrops (EH) confirmed by enhanced Magnetic Resonance Imaging (MRI).
METHODS
252 MD patients with EH confirmed by MRI were enrolled. All patients met the diagnostic criteria for MD and underwent intravenous gadolinium injection. After 4 h, MR examinations were performed. The Nakashima grading standard was used to classify EH and evaluate its correlation with clinical features.
RESULTS
Different degrees of EH were shown in all MD patients, and 157 of the 252 (62.3%) patients showed significant EH, 95 of the 252 (37.7%) patients showed mild EH. Only 89 (35.3%) met the diagnostic criteria for definite MD, and the remaining 163 (64.7%) patients met the diagnostic criteria for probable MD. Compared with patients with unilateral EH, the symptoms of the first affected ear of patients with bilateral EH were more serious. The degree of EH was related to the degree of hearing loss (p < 0.05).
CONCLUSION
MRI with intravenous gadolinium injection can provide a better assessment of EH in MD patients. The clinical features of MD patients with EH confirmed by enhanced MRI did not fully meet the existing diagnostic criteria for definite MD. Including the diagnosis of EH in the diagnostic criteria of MD can increase the diagnosis rate of MD. The degree and distribution of EH may be related to the degree of hearing loss.
目的
分析和总结经增强磁共振成像（MRI）证实内淋巴积水（EH）的梅尼埃病（MD）患者的临床特征和影像特征。
方法
纳入 252 例经 MRI 证实为 EH 的 MD 患者。所有患者均符合 MD 诊断标准，并进行静脉注射钆造影。4 小时后进行 MRI 检查。采用 Nakashima 分级标准对内淋巴积水进行分级，并评估其与临床特征的相关性。
结果
所有 MD 患者均显示不同程度的 EH，252 例患者中 157 例（62.3%）有明显 EH，252 例患者中 95 例（37.7%）有轻度 EH。仅 89 例（35.3%）符合明确 MD 的诊断标准，其余 163 例（64.7%）符合可能 MD 的诊断标准。与单侧 EH 患者相比，双侧 EH 患者第一受累耳的症状更为严重。EH 程度与听力损失程度相关（p<0.05）。
结论
静脉注射钆增强 MRI 可对内淋巴积水患者进行更好的评估。经增强 MRI 证实 EH 的 MD 患者的临床特征并未完全符合现有的明确 MD 诊断标准。将 EH 的诊断纳入 MD 的诊断标准中可能会提高 MD 的诊断率。EH 的程度和分布可能与听力损失程度有关。
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