摘要目的 通过经鼓室内注射造影剂钆,行内耳三维快速液体衰减反转恢复核磁共振(3D-FLAIR MRI)扫描,探讨梅尼埃病膜迷路积水显像的阳性率及对于梅尼埃病的诊断价值.方法 对2010年3月至2011年2月,福建医科大学附属第一医院耳鼻咽喉头颈外科51例梅尼埃病患者经鼓膜双侧鼓室内注入钆喷酸葡胺稀释液,24h后进行内耳3D-FLAlR MRI扫描,并对检查结果进行总结、分析,同时与前庭诱发的肌源性电位(VEMP)及甘油实验结果进行比较.结果 磁共振成像显示造影剂钆分布到内耳外淋巴间隙,使外淋巴液显影增强,从而区分出内、外淋巴间隙.对梅尼埃病患者内耳膜迷路积水显示的阳性率为96.1％(49/51),与VEMP及甘油试验的阳性率相比差异有统计学意义(P＜0.05).51例患者随访未见鼓膜穿孔、感染等并发症.结论 经鼓室钆注射内耳成像技术在梅尼埃病患者膜迷路积水中具有较高的阳性率,虽为有创性检查但不良反应较小,对于梅尼埃病具有重要的诊断价值和临床意义.

abstractsObjective To explore the positive visualization rate of endolymph space in Meniere's disease(MD)by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging(3D-FLAIR MRI)and assess its diagnostic value of MD.Methods 3D-FLAIR MRI was performed at 24 h after an intratympanic injection of gadolinium diethylenetriamine penta-acetic acid in 51 MD patients.Then the examination results were summarized,analyzed and compared with those of vestibular evoked myogenic potential(VEMP)and glycerol tests.Results Gadolinium was found in perilymph inside inner ear.Furthermore the border between perilymph and endolymph was visible so that endolymphatic space was distinctly visualized on 3D-FLAIR MRI.Forty-nine(96.1％)patients demonstrated the signs of endolymphatic hydrops.Statistically significant differences existed between the results of 3D-FLAIR MRI and those of VEMP and glycerol tests(P ＜ 0.05).No complication of tympanic membrane perforation or infection was observed.Conclusion After an intratympanic injection of gadolinium,3D-FLAIR MRI has a higher positive rate in MD patients.Though as an invasive procedure,it has fewer side effects and will become an important diagnostic tool for MD.