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膜迷路积水的影像学表现及其与梅尼埃病患者的临床特征、听觉-前庭功能和精神障碍的相关性。

Endolymphatic hydrops imaging and correlation with clinical characteristics, audiovestibular function and mental impairment in patients with Meniere's disease.

机构信息

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, People's Republic of China.

Department of Radiology, Wuhan No. 1 Hospital, Zhongshan Avenue #215, Qiaokou District, Wuhan, 430022, Hubei, People's Republic of China.

出版信息

Eur Arch Otorhinolaryngol. 2023 Sep;280(9):4027-4036. doi: 10.1007/s00405-023-07899-w. Epub 2023 Feb 27.

Abstract

PURPOSE

MR imaging was used to visualize the vestibular and cochlear endolymphatic hydrops in patients with Meniere's disease (MD). The relationship between the degree of hydrops and clinical characteristics, audiovestibular function, anxiety and depression state in MD patients.

METHODS

70 patients with definitely or probably unilateral Meniere's disease received bilateral intratympanic gadolinium administration and MR scanning. The degree of bilateral vestibular and cochlea hydrops were analyzed and evaluated by three-dimensional real inversion recovery (3D-real IR) sequence, and the correlation between the grades of endolymphatic hydrops (EH) and disease course, vertigo grading assessment, the duration of vertigo, hearing loss level, caloric test, vestibular myogenic evoked potential (VEMP), electrocochleogram (EcoG), vertigo disability scale (physical, emotional, functional), anxiety and depression scale were studied.

RESULTS

It was found that the vestibule and cochlea EH of the affected and the contralateral ear had different degrees of hydrops and there was no statistical difference between the left and right vestibules. The degree of vestibule EH (V-EH) was significantly positively correlated with the degree of cochlear EH (C-EH). C-EH and hearing loss level were positively correlated with EcoG. There was positive correlation between vestibular EH and hearing loss level, VEMP, caloric test, disease course or vertigo duration. There was a negative relationship between Dizziness Handicap Inventory (Emotion) (DHI(E)) and VEMP. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores were positive correlated with DHI(E) and DHI total scores in MD patients.

CONCLUSION

Endolymph-enhancing MRI was used as an important imaging method for the diagnosis of labyrinthine hydrops in Meniere's disease. There were certain correlation between EH and the degree of vertigo attack, hearing loss level, vestibular function, and further changes in anxiety and depression emotion.

摘要

目的

磁共振成像(MR 成像)用于可视化梅尼埃病(MD)患者的前庭和耳蜗内淋巴积水。探讨 MD 患者内淋巴积水程度与积水、临床特征、听觉前庭功能、焦虑和抑郁状态的关系。

方法

70 例单侧或双侧梅尼埃病患者行双侧鼓室内钆造影和 MR 扫描。采用三维真实反转恢复(3D-real IR)序列分析和评估双侧前庭和耳蜗内淋巴积水程度,分析内淋巴积水(EH)分级与病程、眩晕分级评估、眩晕持续时间、听力损失程度、冷热试验、前庭肌源性诱发电位(VEMP)、耳蜗电图(EcoG)、眩晕残疾量表(躯体、情感、功能)、焦虑和抑郁评分的相关性。

结果

发现患侧和对侧耳的前庭和耳蜗 EH 有不同程度的积水,左右前庭无统计学差异。前庭 EH 程度(V-EH)与耳蜗 EH 程度(C-EH)呈显著正相关。C-EH 与听力损失程度呈正相关,EcoG 与 C-EH 呈正相关。前庭 EH 与听力损失程度、VEMP、冷热试验、病程或眩晕持续时间呈正相关。眩晕残疾量表(情感)(DHI(E))与 VEMP 呈负相关。梅尼埃病患者的自评焦虑量表(SAS)和自评抑郁量表(SDS)评分与 DHI(E)和 DHI 总分呈正相关。

结论

内淋巴增强 MRI 作为一种重要的影像学方法,可用于诊断梅尼埃病的迷路积水。EH 与眩晕发作程度、听力损失程度、前庭功能等有一定的相关性,进一步影响焦虑和抑郁情绪。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca9/10382354/bc9cd6390b0a/405_2023_7899_Fig1_HTML.jpg

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