Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Otol Neurotol. 2024 Oct 1;45(9):e624-e629. doi: 10.1097/MAO.0000000000004309.
Bilateral high signal intensity (SI) in the endolymphatic duct (ED) on magnetic resonance imaging (MRI) has been reported as a common characteristic in ears with large vestibular aqueduct syndrome (LVAS). However, the significance of bilateral high SI in the ED remains unknown. The present study aimed to compare the correlation between SI in the ED and the clinical manifestations in various otological disorders and consider the significance of the MRI findings.
Retrospective study.
University hospital.
The study included 2,450 ears from 1,225 patients with various otological disorders.
All ears underwent 3T enhanced MRI and were evaluated for the degree of endolymphatic hydrops (EH) and the SI ratios (SIRs; i.e., the calculation between SIs in the ED and those in the cerebellum).
The imaging findings were compared with their clinical symptoms.
Ears with bilateral high SIRs in the ED tended to have considerably less occurrence of EH in both the cochlea and vestibule than those with bilateral low SIRs. Ears with SIR ≥8 showed significantly elevated hearing thresholds at lower frequencies on pure-tone audiometry, although they exhibited a markedly lower incidence of cochlear EH than those with SIR <8. Moreover, ears with vertigo exhibited notably higher SIRs than those without vertigo.
Bilateral high SI in the ED on MRI may reflect pathophysiology underlying sensorineural hearing loss and vestibular symptoms, which are not associated with EH formation.
磁共振成像（MRI）上内淋巴管（ED）的双侧高信号强度（SI）已被报道为大前庭水管综合征（LVAS）耳部的常见特征。然而，ED 双侧高 SI 的意义尚不清楚。本研究旨在比较 ED 中的 SI 与各种耳科疾病的临床表现之间的相关性，并考虑 MRI 结果的意义。
回顾性研究。
大学医院。
本研究纳入了 1225 名各种耳科疾病患者的 2450 只耳朵。
所有耳朵均接受 3T 增强 MRI 检查，并评估内淋巴积水（EH）的程度和 SI 比值（SIR；即 ED 和小脑的 SI 之间的计算）。
将影像学发现与临床症状进行比较。
ED 双侧高 SIR 的耳朵在耳蜗和前庭中 EH 的发生倾向于明显少于双侧低 SIR 的耳朵。SIR≥8 的耳朵在纯音测听中低频的听力阈值显著升高，尽管它们的耳蜗 EH 发生率明显低于 SIR<8 的耳朵。此外，有眩晕的耳朵的 SIR 明显高于没有眩晕的耳朵。
MRI 上 ED 的双侧高 SI 可能反映了与 EH 形成无关的感音神经性听力损失和前庭症状的病理生理学。
