Clinical Value Of Intravenous Gadolinium-enhancement 3D-FLAIR MR Imaging In Meniere’s Disease

Objective: To evaluate the clinical value of intravenous gadolinium-enhancement3D-FLAIR MR imaging in Meniere’s disease.Methods: Data of 53 patients with clinically diagnosed vertigo-associated inner ear pathology were analyzed.106 ears were divided into four groups,definite Meniere’s disease,probable Meniere’s disease,asymptomatic,and other vertigo-associated inner ear pathology.All patients underwent pure audiometry and gadolinium contrast examination in the ear.A 3D-FLAIR sequence 4 hours after intravenous gadolinium injection was performed to visualize the endolymph and perilymph.The presence of endolymphatic hydrops and its degree,visually increased perilymphatic enhancement,and perilymphatic signal intensity ratio were evaluated.Chi-square test,adjusted Chi-square test,or Fisher exact probability method were used to compare the difference of endolymphatic hydrops and visually increased perilymphatic enhancement between the definite Meniere’s disease group and the other three groups.The perilymphatic signal intensity ratio between the definite Meniere’s disease group and other vertigo-associated inner ear pathology group was compared with The independent sample T-test.Take the group of other vertigo-associated inner ear pathology as the control group,calculate the sensitivity,specificity,positive predictive value,and negative predictive value of the endolymphatic hydrops,and visually increased perilymphatic enhancement in the diagnosis of Meniere’s disease.The correlation between the degree of endolymphatic hydrops and the degree of hearing loss was analyzed in the definite Meniere’s disease group.Results:Endolymphatic hydrops was present in 33(89.2%,33/37)of the definite Meniere’s disease group and in 4(11.4%,4/35)of the ears with other vertigoassociated inner ear pathology group(P<0.001),the sensitivity,specificity,positive predictive value and negative predictive value of endolymphatic hydrops in the diagnosis of Meniere’s disease were 89%,88%,89% and 89%;visually increased perilymphatic enhancement was present in 27(73.0%,27/37)of the definite Meniere’s disease group and in 7(20.0%,7/35)of the ears with other vertigoassociated inner ear pathology group(P<0.001),the sensitivity,specificity,positive predictive value and negative predictive value of visually increased perilymphatic enhancement in the diagnosis of Meniere’s disease were 73%,80%,79% and 74%;the combination endolymphatic hydrops and visually increased perilymphatic enhancement were present in 26(70.3%,26/37)of the definite Meniere’s disease group compared with 2(5.7%,2/35)ears with other vertigo-associated inner ear pathology group(P<0.001),the sensitivity,specificity,positive predictive value and negative predictive value of this combination in the diagnosis of Meniere’s disease were 70%,94%,93% and 75%.Endolymphatic hydrops was present in 5(55.6%,5/9)of the probable Meniere’s disease group,the difference was statistically significant compared with the definite Meniere’s disease group(P=0.017);visually increased perilymphatic enhancement was present in 3(33.3%,3/9)of the probable Meniere’s disease group,the difference was not statistically significant compared with the definite Meniere’s disease group(P=0.064);the combination endolymphatic hydrops and visually increased perilymphatic enhancement were present in 2(22.2%,2/9)of the probable Meniere’s disease group,the difference was statistically significant compared with the definite Meniere’s disease group(P=0.023).Endolymphatic hydrops or visually increased perilymphatic enhancement was present in 1(4.0%,1/25)of the asymptomatic group respectively,the difference was statistically significant compared with the definite Meniere’s disease group(P<0.001);the combination endolymphatic hydrops and visually increased perilymphatic enhancement was none in the asymptomatic group,the difference was statistically significant compared with the definite Meniere’s disease group(P<0.001).The degree of the endolymphatic hydrops was significantly correlated with the degree of hearing loss(r=0.78,P<0.001),with the degree of endolymphatic hydrops increased,the more severe the hearing loss.Conclusion : Intravenous gadolinium-enhancement delayed 3D-FLAIR MR imaging can be used to diagnose Meniere’s disease,the combination of endolymphatic hydrops and visually increased perilymphatic enhancement will improve the accuracy of the diagnosis,and the degree of vestibule endolymphatic hydrops is also helpful to evaluate the staging of the illness.