不同3T核磁共振机内耳内淋巴影像学测定比较研究
发布时间：2018-11-25 18:47
【摘要】：目的：采用经咽鼓管鼓室内导入造影剂钆喷酸葡胺稀释液、内耳三维快速液体衰减反转恢复磁共振扫描(three dimensional fluid attenuated inversion recovery magnetic resonance imaging,3D-FLAIR MRI)技术,在正常内耳内淋巴显像基础上,采用客观统一的内淋巴间隙核磁采集和测定方法,探讨此方法得出内耳内淋巴液截面积的测定值是否可广泛应用于评价临床对照研究的科学性、准确性和可行性。 方法：将12例正常受试者随机分成A组6例、B组6例,采用经咽鼓管置管中耳腔给药的方法,在耳内窥镜监视下给入稀释的钆喷酸葡胺,给药24小时后A组6例在同仁医院3T磁共振机(GE, HDX,美国)；B组6例在北京医院3T磁共振机(PHILIPS, ACHIEVA,荷兰)行3D-FLAIR MRI扫描显影。耳蜗部采用斜矢位蜗轴截取平面,测量耳蜗底转内淋巴间隙和总淋巴间隙面积；前庭部采用冠状位前庭长轴垂直截取平面,测量前庭部内淋巴间隙(椭圆囊和球囊的面积之和)和总淋巴间隙。给药后1周、1个月时进行纯音测听和声阻抗测试。 结果：1、12例正常受试者咽鼓管内置管时出现一过性刺痛,4例正常受试者给药过程中出现一过性旋转性眩晕,12例正常受试者出现耳胀闷感,3例正常受试者出现听力下降,6例正常受试者给药时出现流水样耳鸣,1例正常受试者出现咳嗽。上述症状均在给药结束后5分钟内消失。 2、A组6例与B组6例正常受试者受试耳的内耳3D-FLAIR MRI,均可显示内耳的耳蜗、前庭和(或)半规管的外淋巴间隙广泛可见造影剂钆增强区影,可以区分内、外淋巴间隙的边界和清晰显像内淋巴的情况。 3、A组6例正常受试者的耳蜗和前庭的内淋巴间隙评定值分别为0.19±0.04和0.15±0.03；B组6例正常受试者的耳蜗和前庭的内淋巴间隙评定值分别为0.31±0.06和0.32±0.05。 A组6例正常受试者和B组6例正常受试者之间耳蜗的内淋巴间隙评定值比较无明显统计学差异(P0.05)；前庭部的内淋巴间隙评定值比较无明显统计学差异(P0.05)。 4、给药1月后,12例正常受试者复查纯音测听和声阻抗测试都在正常范围,与受试前纯音测听和声阻抗测试结果相较,未见明显差异。 结论：经咽鼓管鼓室内导入造影剂钆,内耳3D-FLAIR MRI,采用客观统一的内淋巴间隙核磁图像采集和测定方法,得到的内淋巴间隙的评定值是具有科学、准确及可比性的,是具有可被广泛应用于临床对照研究的方法；本研究为进一步以内淋巴积水为主要病理特征的一系列内耳病的客观诊断奠定了必要的基础及指导治疗与预后。正常内耳内淋巴间隙的客观评定值的影像学确定,为内淋巴积水程度与临床症状严重程度的相关性研究提供了参考基础。
[Abstract]:Objective: to introduce the contrast agent meglumine gadolpate into the eustachian tube tympanum and restore magnetic resonance imaging (three dimensional fluid attenuated inversion recovery magnetic resonance imaging,3D-FLAIR MRI) technique with 3D fast fluid attenuation inversion in the inner ear. On the basis of endolymphatic imaging of normal inner ear, an objective and unified method of nuclear magnetic resonance (NMR) measurement of endolymphatic space was used to investigate whether this method could be widely used to evaluate the scientificalness of clinical controlled study. Accuracy and feasibility. Methods: 12 normal subjects were randomly divided into two groups: group A (n = 6) and group B (n = 6). 24 hours after administration, 6 patients in group A were treated with 3T magnetic resonance machine (GE, HDX, USA) in Tongren Hospital. Group B (6 cases) were examined by 3D-FLAIR MRI in 3 T magnetic resonance machine (PHILIPS, ACHIEVA, Netherlands) of Beijing Hospital. The cochlear space and total lymphoid space were measured by oblique sagittal axis of cochlea. The long vestibular axis of the vestibular vestibule was used to measure the total lymphatic space (the sum of the area of the elliptical sac and balloon) and the total lymphatic space. Pure tone audiometry and acoustic impedance test were performed 1 week and 1 month after administration. Results: (1) there were transient stinging pain in eustachian tube placement in 12 normal subjects, transient rotational vertigo in 4 normal subjects, ear distention in 12 normal subjects, hearing loss in 3 normal subjects. In 6 cases of normal subjects, fluid-like tinnitus and cough occurred in 1 case of normal subjects. The above symptoms disappeared within 5 minutes after administration. 2The inner ear 3D-FLAIR MRI, of 6 subjects in group A and 6 normal subjects in group B could show the cochlea of the inner ear, and the contrast agent gadolinium enhancement area could be widely seen in the vestibular and / or semicircular perilymphatic space, which could be distinguished from the inner ear. The boundary of the perilymphatic space and clear imaging of the endolymphes. 3 in group A, the assessment values of endolymphatic space in cochlea and vestibule of 6 normal subjects were 0.19 卤0.04 and 0.15 卤0.03, respectively. In group B, the assessment values of endolymphatic space in cochlea and vestibule of 6 normal subjects were 0.31 卤0.06 and 0.32 卤0.05, respectively. There was no significant difference in the assessment value of endolymphatic space between group A (6 normal subjects) and group B (6 normal subjects) (P0.05), but there was no significant difference between vestibule and vestibule (P0.05). 4. One month after administration, 12 normal subjects were examined in the normal range of pure tone audiometry and acoustic impedance test, and there was no significant difference between pure tone audiometry and acoustic impedance test. Conclusion: through the introduction of gadolinium into the eustachian tube tympanum, the inner ear 3D-FLAIR MRI, adopts objective and unified method of collecting and measuring endolymphatic space nuclear magnetic resonance image. The evaluated value of endolymphatic space is scientific, accurate and comparable. It is a method which can be widely used in clinical controlled study. This study laid a foundation for the objective diagnosis of endolymphatic hydronephrosis, which is the main pathological feature of endolymphatic hydrops, and provided guidance for the treatment and prognosis of endolymphatic hydronephrosis. The imaging determination of the objective assessment value of endolymphatic space in the normal inner ear provides a reference basis for the study of the correlation between the degree of endolymphatic hydrops and the severity of clinical symptoms.
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R764.04
本文编号：2357076
[Abstract]:Objective: to introduce the contrast agent meglumine gadolpate into the eustachian tube tympanum and restore magnetic resonance imaging (three dimensional fluid attenuated inversion recovery magnetic resonance imaging,3D-FLAIR MRI) technique with 3D fast fluid attenuation inversion in the inner ear. On the basis of endolymphatic imaging of normal inner ear, an objective and unified method of nuclear magnetic resonance (NMR) measurement of endolymphatic space was used to investigate whether this method could be widely used to evaluate the scientificalness of clinical controlled study. Accuracy and feasibility. Methods: 12 normal subjects were randomly divided into two groups: group A (n = 6) and group B (n = 6). 24 hours after administration, 6 patients in group A were treated with 3T magnetic resonance machine (GE, HDX, USA) in Tongren Hospital. Group B (6 cases) were examined by 3D-FLAIR MRI in 3 T magnetic resonance machine (PHILIPS, ACHIEVA, Netherlands) of Beijing Hospital. The cochlear space and total lymphoid space were measured by oblique sagittal axis of cochlea. The long vestibular axis of the vestibular vestibule was used to measure the total lymphatic space (the sum of the area of the elliptical sac and balloon) and the total lymphatic space. Pure tone audiometry and acoustic impedance test were performed 1 week and 1 month after administration. Results: (1) there were transient stinging pain in eustachian tube placement in 12 normal subjects, transient rotational vertigo in 4 normal subjects, ear distention in 12 normal subjects, hearing loss in 3 normal subjects. In 6 cases of normal subjects, fluid-like tinnitus and cough occurred in 1 case of normal subjects. The above symptoms disappeared within 5 minutes after administration. 2The inner ear 3D-FLAIR MRI, of 6 subjects in group A and 6 normal subjects in group B could show the cochlea of the inner ear, and the contrast agent gadolinium enhancement area could be widely seen in the vestibular and / or semicircular perilymphatic space, which could be distinguished from the inner ear. The boundary of the perilymphatic space and clear imaging of the endolymphes. 3 in group A, the assessment values of endolymphatic space in cochlea and vestibule of 6 normal subjects were 0.19 卤0.04 and 0.15 卤0.03, respectively. In group B, the assessment values of endolymphatic space in cochlea and vestibule of 6 normal subjects were 0.31 卤0.06 and 0.32 卤0.05, respectively. There was no significant difference in the assessment value of endolymphatic space between group A (6 normal subjects) and group B (6 normal subjects) (P0.05), but there was no significant difference between vestibule and vestibule (P0.05). 4. One month after administration, 12 normal subjects were examined in the normal range of pure tone audiometry and acoustic impedance test, and there was no significant difference between pure tone audiometry and acoustic impedance test. Conclusion: through the introduction of gadolinium into the eustachian tube tympanum, the inner ear 3D-FLAIR MRI, adopts objective and unified method of collecting and measuring endolymphatic space nuclear magnetic resonance image. The evaluated value of endolymphatic space is scientific, accurate and comparable. It is a method which can be widely used in clinical controlled study. This study laid a foundation for the objective diagnosis of endolymphatic hydronephrosis, which is the main pathological feature of endolymphatic hydrops, and provided guidance for the treatment and prognosis of endolymphatic hydronephrosis. The imaging determination of the objective assessment value of endolymphatic space in the normal inner ear provides a reference basis for the study of the correlation between the degree of endolymphatic hydrops and the severity of clinical symptoms.
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R764.04
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