钆造影核磁共振成像在梅尼埃病内耳膜迷路积水诊断中的应用OA

Objective To explore the application value of gadolinium-enhanced magnetic resonance imaging(MRI)in the diagnosis of endolymphatic hydrops of the inner ear in patients with Meniere's disease.Methods A total of 78 patients with Meniere's disease treated in our hospital were enrolled.The consistency between gadolinium-enhanced MRI and clinical diagnosis in identifying endolymphatic hydrops of the inner ear in patients with Meniere's disease was analyzed.The results of pure tone audiometry,electrocochleography,videonystagmography(VNG)and vestibular evoked myogenic potential(VEMP)were compared among patients with different degrees of vestibular and cochlear hydrops.The correlations of vestibular and cochlear hydrops severity with the above examination indicators were further analyzed.Results Gadolinium-enhanced MRI showed a sensitivity of 91.30%,a specificity of 93.75%,an accuracy of 92.31%,a positive predictive value of 95.45%,and a negative predictive value of 88.24%for diagnosing endolymphatic hydrops of the inner ear in patients with Meniere's disease,which had high consistency with the clinical diagnosis with a Kappa value of 0.843.The pure-tone threshold and the abnormal rates of VEMP and VNG in patients with severe vestibular hydrops were significantly higher than those in patients with mild vestibular hydrops or without vestibular hydrops(P<0.05).Patients with mild vestibular hydrops also presented remarkably higher pure-tone threshold and abnormal rates of VEMP and VNG compared with those without vestibular hydrops(P<0.05).There was no significant difference in the negative summating potential/action potential(-SP/AP)ratio among patients with different degrees of vestibular hydrops(P>0.05).The pure-tone threshold and-SP/AP ratio in patients with severe cochlear hydrops were significantly higher than those in patients with mild cochlear hydrops or without cochlear hydrops(P<0.05).The pure-tone threshold and-SP/AP ratio in patients with mild cochlear hydrops were also significantly increased compared with patients without cochlear hydrops(P<0.05).No significant differences were found in the abnormal rates of VEMP and VNG among patients with different degrees of cochlear hydrops(P>0.05).Spearman correlation analysis showed that the degree of vestibular hydrops was significantly positively correlated with pure-tone threshold,VEMP abnormal rate and VNG abnormal rate(P<0.05);the degree of cochlear hydrops was significantly positively correlated with pure-tone threshold and-SP/AP ratio(P<0.05).Conclusion Gadolinium-enhanced MRI can effectively diagnose endolymphatic hydrops of the inner ear in patients with Meniere's disease,and clarify the location and severity of hydrops.Its diagnostic results are correlated with pure tone audiometry,electrocochleography,VNG and VEMP results,which can assist in evaluating the condition of Meniere's disease and guiding clinical treatment.