首页 > 过刊浏览 > 文章详情

经静脉内耳钆造影MRI对可疑梅尼埃病的诊断价值

Diagnostic Value of Intravenous Gadolinium Inner Ear MRI in Suspected Meniere's Disease

于学文;孙立新;胡娜;李进叶;田静;赵慧;巩若箴;

1:山东省耳鼻喉医院

2:山东大学附属山东省耳鼻喉医院影像科

在线阅读

摘要

目的探讨经静脉内耳钆造影核磁共振(MRI)检查对可疑梅尼埃病(Ménière’s disease)的诊断价值。方法回顾性分析130例可疑梅尼埃病患者的临床资料,以2017年梅尼埃病诊断和治疗指南作为诊断标准,评价经静脉内耳钆造影MRI检查对梅尼埃病诊断的价值。结果 130例可疑梅尼埃病患者中,临床确诊为梅尼埃病80例,突聋21例,前庭性偏头痛20例,迟发型迷路积水等其他疾病9例。80例梅尼埃病患者中,内耳钆造影阳性68例,阴性12例;50例非梅尼埃病患者中,内耳钆造影阳性9例,阴性41例。内耳钆造影诊断梅尼埃病的灵敏度、特异度、阳性预测值和阴性预测值分别为88.3%、77.4%、85.0%、82.0%;经静脉内耳钆造影ROC曲线下面积及95%可信区间为83.5%(76.4%～89.7%);经静脉内耳钆造影诊断结果与临床诊断结果的一致性较好(κ=0.66)。结论经静脉内耳钆造影可以作为一种诊断梅尼埃病的可靠的无创性检查方法。

关键词

梅尼埃病;诊断;经静脉内耳钆造影

基金项目(Foundation):

作者

于学文;孙立新;胡娜;李进叶;田静;赵慧;巩若箴;

参考文献

1 Cureoglu S,Da Costa Monsanto R,Paparella MM.Histopathology of Meniere’s disease[J].Oper Tech Otolayngol Head Neck Surg,2016,27:194.

2 James AL,Thorp MA.Meniere's disease[J].BMJ Clin Evid,2007,3:505.

3 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.梅尼埃病诊断和治疗指南(2017)[J].中华耳鼻咽喉头颈外科杂志,2017,52:167.

4 Hamid MA.Ménière’s disease[J].Practical Neurology,2009,9:157.

5 Sajjadi H,Paparella MM.Meniere's disease[J].The Lancet,2008,372:406.

6 Nakashima T,Naganawa S,Sugiura M,et al.Visualization of endolymphatic hydrops in patients with Meniere's disease[J].The Laryngoscope,2007,117:415.

7 刘芳,余力生,黄魏宁,等.梅尼埃病内淋巴积水影像学测定[J].中国耳鼻咽喉头颈外科,2010,17:531.

8 Nakashima T,Naganawa S,Pyykko I,et al.Grading of endolymphatic hydrops using magnetic resonance imaging[J].Acta Oto-Laryngologica,2009,129:5.

9 Baloh RW.Prosper Meniere and his disease[J].Archives of neurology,2001,58:1151.

10 Rauch SN,Merchant SA,Thedinger B.Meniere's syndrome and endolymphatic hydrops:double-blind temporal bone study [J].Annals of Otology,Rhinology & Laryngology,1989,98:873.

11 Yamazaki M,Naganawa S,Kawai H,et al.Gadolinium distribution in cochlear perilymph:differences between intratympanic and intravenous gadolinium injection[J].Neuroradiology,2012,54:1161.

12 Naganawa S,Nakashima T.Visualization of endolymphatic hydrops with MR imaging in patients with Ménière's disease and related pathologies:current status of its methods and clinical significance[J].Japanese Journal of Radiology,2014,32:191.

13 章梦蝶,金占国,徐先荣,等.静脉甘油试验和鼓室钆造影在梅尼埃病诊断中的价值[J].中华耳科学杂志,2016,14:499.

14 Baráth K,Schuknecht B,Naldi AM,et al.Detection and grading of endolymphatic hydrops in Menière disease using MR imaging[J].American Journal of Neuroradiology,2014,35:1387.

15 Fukuoka H,Takumi Y,Tsukada K,et al.Comparison of the diagnostic value of 3 TMRI after intratympanic injection of GBCA,electrocochleography,and the glycerol test in patients with Meriere’s disease[J].Acta Oto-laryngologica,2012,132:141.

16 刘旭晖,黄魏宁,孟曦曦,等.梅尼埃病患者内耳内淋巴间隙显像与临床特征的相关性研究[J].临床耳鼻咽喉头颈外科杂志,2017,31:608.

17 Cho YS,Ahn JM,Choi JE,et al.Usefulness of intravenous gadolinium inner ear MR imaging in diagnosis of Ménière's disease[J].Scientific Reports,2018,8:17562.

18 严进,成红政,刘爱国.梅尼埃病患者前庭内淋巴积水程度与其症状和听觉及前庭功能的相关性分析[J].听力学及言语疾病杂志,2015,23:220.

19 姚士红,金攀,胡涛,等.梅尼埃病患者MRI造影所见内淋巴积水程度的临床相关性研究[J].中国中西医结合耳鼻咽喉科杂志,2017,25:139.

本文信息

PDF(464K)

本文关键词相关文章

梅尼埃病诊断经静脉内耳钆造影

本文作者相关文章

于学文孙立新胡娜李进叶田静赵慧巩若箴