经鼓室钆注射内耳造影技术在梅尼埃病中的临床诊断应用价值研究

发布时间：2018-05-18 12:31

本文选题：梅尼埃病 + 膜迷路积水　；参考：《福建医科大学》2012年硕士论文

【摘要】：目的：本研究旨在通过经鼓室内注射钆造影剂，24小时后行内耳三维快速液体衰减反转恢复核磁共振(three-dimensional fluid-attenuated inversionrecovery magnetic resonance imaging，3D-FLAIR MRI)扫描，与传统经典的膜迷路积水检查方法，如前庭诱发肌源性电位(vestibular evoked myogenicpotential，VEMP)及耳蜗电图（eleetrocochleography，EcochG）进行比较，探讨经鼓室钆注射内耳造影技术在梅尼埃病膜迷路积水中显像的阳性率及对于梅尼埃病的诊断应用价值。方法：28例梅尼埃病患者，其中1例为双侧发病，共29患耳，经鼓膜穿刺鼓室内注入钆喷酸葡胺稀释液，，24小时后进行内耳3D-FLAIR MRI扫描，并对检查结果进行总结、分析，同时与同期进行的VEMP及耳蜗电图检查结果进行比较。结果：29耳成功造影28耳，成功率达96.6%。28耳造影成功患者内耳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。28耳中诊断膜迷路积水有26例，阳性率为92.9%（26/28），同期进行的VEMP检查阳性率为58.6%，耳蜗电图检查阳性率为60.7%，均小于钆注射内耳造影技术，比较有统计学差异（P0.0125）。28例患者随访未见鼓膜穿孔、感染等并发症。结论：经鼓室钆注射内耳造影技术是检测膜迷路积水的可靠的有效检查手段。相比较传统经典检查方法如VEMP、耳蜗电图，阳性率更高，评估方法更科学，虽为有创性检查但副作用较小，对于梅尼埃病具有重要的诊断价值和临床意义。
[Abstract]:Objective: the aim of this study was to perform three-dimensional fluid-attenuated inversionrecovery magnetic resonance imaging3D-flair MRI scanning in the inner ear after 24 hours of intratympanic injection of gadolinium contrast agent. For example, vestibular evoked myogenic potentialpotential (VEMPP) and electrocochocardiography (EcochG) were compared to investigate the positive rate of intraventricular gadolinium injection in the diagnosis of Meniere's disease in membranous labyrinthine hydrops and its value in the diagnosis of Meniere's disease. Methods Twenty eight patients with Meniere's disease, including 1 patient with bilateral disease (29 ears), underwent 3D-FLAIR MRI scanning of the inner ear 24 hours after injection of Gadolinium Gadolinium poumate in the tympanic chamber through the tympanic membrane, and the results were summarized and analyzed. At the same time, the results of VEMP and electrocochocardiography were compared. Results Twenty eight ears were successfully examined, the success rate was 96.60.28 ears were successfully examined by magnetic resonance imaging (MRI) to show that the contrast agent gadolinium was distributed into the outer lymphoid space of the inner ear, which enhanced the development of perilymph and distinguished the inner part. In the perilymphatic space. 28 ears, 26 cases were diagnosed with membranous labyrinthine hydrops, the positive rate was 92.9 / 28, the positive rate of VEMP was 58.6, and the positive rate of electrocochocardiography was 60.7, which was less than that of gadolinium injection of inner ear. There were no complications such as tympanic membrane perforation, infection and so on. Conclusion: Intratympanic gadolinium injection is a reliable and effective method for the detection of membranous labyrinthine hydrops. Compared with traditional classical examination methods such as VEMPand electrocochocardiography, the positive rate is higher, the evaluation method is more scientific, although it is invasive examination, but the side effect is small, it has important diagnostic value and clinical significance for Meniere's disease.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R764

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