JOURNAL ARTICLE

[Application of gadolinium enhanced magnetic resonance imaging of inner ear to observe bilateral inner ears hydrops in patients with unilateral Meniere's disease]

Y P Liu, J Yang, H Jia, J Shi
Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery 2016 August 20, 30 (16): 1290-1296
29797973
Objective: Department of Otolaryngology Head and Neck Surgery,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai Jiaotong University Ear Institute,Shanghai,200092,China This study was designed to study the correlation between endolympahatic hydrops image results and auxiliary examinations by magnetic resonance imaging after intratympanic administration of gadolinium in both ears in unilateral Meniere's disease patients.Meanwhile,the contralateral endolympahatic hydrops of the "asym ptomatic " ear in patients with unilateral Meniere's was also observed. Method: Thirty-one patients with unilateral Meniere's disease were enrolled in this study.All the patients underwent pure tone audiometry,electrocochleography(ECochG),cervical-vestibular evoked myogenic potentials(cVEMP) before intratympanic gadolinium contrast agents injected.All the patients underwent three-dimensional fast fluid attenuated inversion recovery sequence magnetic resonance imaging(3D-FLAIR MRI) after intratympanic gadolinium contrast agents injected 24 hours.The images were graded in accordance with the severity of endolympatic hydrops.Spearman correlation analysis was performed between the scores of the images and results of auxiliary examination results.Meanwhile,Student's t test was performed for the significance test of the age,duration of the disease and the hearing level of the affected ears between the group with contralateral endolympatic hydrops and the group without contralateral endolympatic hydrops. Result: Pure tone average and the degree of the cochlear hydrops( r =0.383, P <0.05),the SP/AP ratio and the degree of the cochlear hydrops( r =0.496, P <0.01),and interaural amplitude difference and the degree of the vestibular hydrops( r =0.635, P <0.01) showed a significant correlation.The duration of the disease[(6.7±6.3) years vs(2.9±3.1) years, P <0.05] and the hearing level of the affected ear[(70.3±7.4)dB vs(52.5±3.8)dB, P <0.05)] showed a significant difference between the group with contralateral endolympatic hydrops and the group without contralateral endolympatic hydrops. Conclusion: Pure tone average and the degree of the cochlear hydrops,-SP/AP ratio and the degree of the cochlear hydrops,and interaural amplitude difference and the degree of the vestibular hydrops also showed a significant correlation,which suggesting that MRI image can reflect the auditory-vestibular function in patients with Meniere's disease.Endolympatic hydrops and hearing loss are closely related,but not necessarily result in Meniere's disease symptoms.Patients with longer duration of the disease and worse hearing in the affected ears are more likely to develop bilateral endolympatic hydrops.

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