内耳显影对迟发性膜迷路积水诊断的意义

发布时间：2018-09-18 17:44

【摘要】：目的明确鼓室内钆造影剂注射后内耳显影对迟发性膜迷路积水(delayed endolymphatic hydrops,DEH)诊断的临床价值,探讨迟发性膜迷路积水的病理机制。方法 10例DEH患者行双鼓室钆造影剂注射24小时后行三维快速液体衰减反转恢复(three dimensional fluid-attenuated inversion recovery,3D-FLAIR)序列和三维实时反转恢复(three dimensional real inversion recovery,3D-real IR)序列扫描成像,分析患者内淋巴积水的范围及严重程度。结果 10例DEH患者中9例为同侧型,1例为对侧型,均显示单侧或双侧内淋巴积水征象,其中9例同侧型DEH患者中仅1例(11.1%)患侧耳前庭内淋巴显示轻度积水,其余8例(88.9%)均显示患侧前庭内淋巴重度积水;8例(88.9%)同侧型DEH患者患侧耳蜗内淋巴积水,而1例(11.1%)同侧型DEH患者患侧耳蜗内淋巴无积水,9例同侧DEH患者对侧耳均未见前庭、耳蜗内淋巴积水。1例对侧型DEH患者的双侧前庭内淋巴重度积水,右侧耳蜗内淋巴轻度积水,而左侧耳蜗未见积水。结论内淋巴积水是DEH的主要病理因素,鼓室内钆注射后内耳显影能直观地反映出DEH患者内淋巴积水的范围及严重程度。
[Abstract]:Objective to evaluate the clinical value of intratympanic gadolinium contrast injection in the diagnosis of delayed membranous labyrinthine hydrops (delayed endolymphatic hydrops,DEH) and to explore the pathological mechanism of delayed membranous labyrinthine hydrops. Methods Ten patients with DEH were treated with double tympanic cavity gadolinium contrast media injection 24 hours after 24 hours. Three dimensional rapid fluid attenuated inversion (three dimensional fluid-attenuated inversion recovery,3D-FLAIR) sequence and 3D real time reverse restored (three dimensional real inversion recovery,3D-real IR (three dimensional real inversion recovery,3D-real IR) sequence scanning imaging were performed. The extent and severity of endolymphatic hydrops were analyzed. Results 9 out of 10 patients with DEH were ipsilateral and 1 was contralateral, all of them showed unilateral or bilateral endolymphatic hydrops. Of the 9 patients with ipsilateral DEH, only 1 (11.1%) had mild hydrops in the vestibular vestibule of the affected side. The other 8 cases (88.9%) showed severe hydrops of vestibular lymph nodes in 8 cases (88.9%) of ipsilateral DEH patients, while 1 case (11.1%) of ipsilateral DEH patients had no hydronephrosis in 9 cases of ipsilateral DEH patients. No vestibular vestibule was found in 9 cases of ipsilateral DEH patients. There were severe hydrops in bilateral vestibular lymph nodes in 1 cases of contralateral DEH with endolymphatic hydrops in the cochlea, mild hydrops in the right cochlea, but no hydrops in the left cochlea. Conclusion endolymphatic hydronephrosis is the main pathological factor of DEH. The extent and severity of endolymphatic hydronephrosis in DEH patients can be directly reflected by endolymphatic hydrocephalus after intratympanic gadolinium injection.
【作者单位】：复旦大学附属眼耳鼻咽喉科医院耳神经颅底外科卫生部听觉医学重点实验室;浙江省绍兴市第五人民医院耳鼻咽喉科;复旦大学附属眼耳鼻咽喉科医院放射科;
【基金】：国家自然科学基金(81070785;81170909) 卫生公益行业专项基金(201202001)资助
【分类号】：R764.33

【共引文献】