Li Jinye, Wang Linsheng, Hu Na, Kong Xiao, Ge Xiaoqian, Liu Mengxiao, Li Chuanting, Sun Lixin, Gong Ruozhen
Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, 4 Duan Xing-Xi Road, Jinan, China.
MR Scientific Marketing, Diagnostic Imaging, Siemens Healthineers Ltd, Shanghai, China.
Neuroradiology. 2023 Sep;65(9):1371-1379. doi: 10.1007/s00234-023-03176-z. Epub 2023 Jun 17.
To determine whether magnetic resonance imaging (MRI) can improve diagnostic accuracy for definite and probable Ménière's disease (MD) based on perilymphatic enhancement (PE) and endolymphatic hydrops (EH).
363 patients with unilateral MD (probable MD, n = 75 and definite MD, n = 288) were recruited. A three-dimensional zoomed imaging technique with parallel transmission SPACE real inversion recovery was performed 6 h after intravenous gadolinium injection to investigate the presence of PE and to evaluate the grading and location of EH. PE and EH characteristics were analyzed and compared between the probable and definite MD groups.
The cochlear and vestibular EH grading on the affected side was more severe in the definite MD group than that in the probable MD group (P < 0.001). The EH locations within the inner ear on the affected side also differed between the two groups (χ = 81.15, P < 0.001). The signal intensity ratio (SIR) on the affected side was significantly higher in the definite MD group than in the probable MD group (t = 2.18, P < 0.05). The assessment of the combination of PE and EH parameters within the inner ear revealed a higher area under the curve (AUC) in the definite MD group (0.82) compared with the AUCs of the parameters assessed alone.
The assessment of a combination of PE and EH parameters improved the diagnostic accuracy for probable and definite MD, suggesting that MRI findings may be clinically useful in the diagnosis of MD.
基于外淋巴增强（PE）和内淋巴积水（EH），确定磁共振成像（MRI）是否能提高确诊和疑似梅尼埃病（MD）的诊断准确性。
招募了363例单侧MD患者（疑似MD，n = 75；确诊MD，n = 288）。静脉注射钆剂6小时后，采用平行传输SPACE真实反转恢复的三维缩放成像技术，以研究PE的存在情况，并评估EH的分级和位置。分析并比较疑似MD组和确诊MD组的PE和EH特征。
确诊MD组患侧的耳蜗和前庭EH分级比疑似MD组更严重（P < 0.001）。两组患侧内耳内EH的位置也有所不同（χ = 81.15，P < 0.001）。确诊MD组患侧的信号强度比（SIR）显著高于疑似MD组（t = 2.18，P < 0.05）。内耳内PE和EH参数组合的评估显示，确诊MD组的曲线下面积（AUC）（0.82）高于单独评估参数的AUC。
PE和EH参数组合的评估提高了疑似和确诊MD的诊断准确性，表明MRI结果在MD的诊断中可能具有临床应用价值。
