Correlation Between Gadolinium Imaging MRI Presentation And Clinical Features In Meniere’s Disease

ObjectiveThe aim of this study was to assess the degree of lymphatic fluid in the vestibule and cochlea by performing gadolinium imaging MRI of the inner ear in patients with Meniere’s disease,so as to analyze the correlation between the degree of lymphatic fluid in the vestibule and cochlea and the clinical characteristics of the patients.Materials and MethodsOne hundred and sixty-one patients with clinically confirmed Meniere’s disease from September 2019 to June 2022 at Shandong Ear,Nose and Throat Hospital were collected,and pure-tone auditory threshold test(PTA),cochlea electrogram test(EcochG),vestibular evoked myogenic potential(c-VEMP)test and other auditory-vestibular function tests were performed after the outpatient physicians recorded the duration of vertigo illness and vertigo attack duration.All patients were given double doses of gadobetidium contrast intravenously and underwent 3D-FLAIR MRI sequence scans of the inner ear 4 h later,and the degree of vestibular and cochlear effusion was assessed separately using the visual scoring method proposed by Bernaerts.The patients were divided into vestibular group,cochlear group,and vestibular+cochlear group according to the site of fluid accumulation.Applying spss26.0 software,(i)the significance test was performed by chi-square test on the site of endolymphatic effusion and the degree of hearing loss in the affected ear to analyze whether the site of effusion would have an effect on the degree of hearing loss of patients.(ii)Spearman’s rank correlation analysis was used to clarify whether there was a correlation between the degree of endolymphatic effusion and the patient’s age,the duration of vertigo,the duration of vertigo attacks,and the degree of hearing loss.(iii)To analyze whether there is any correlation between the degree of endolymphatic fluid in the cochlea and the results of EcochG examination,the degree of vestibular fluid and the results of c-VEMP examination.ResultsA total of 161 patients with clinically confirmed Meniere’s disease,aged 15-79 years,mean 52.6±13.4 years,with a vertigo duration of 5(0.02,22)years and vertigo duration of 4(0.2,48)hours,were collected in this experiment.All patients obtained satisfactory quality images in gadolinium imaging MRI of the inner ear,and the image analysis determined that there were 163 positive ears with endolymphatic effusion and 9 negative ears with endolymphatic effusion.41 cases had no effusion,23 cases had 1st degree effusion,64 cases had 2nd degree effusion,and 44 cases had 3rd degree effusion in the vestibule of 172 ears;21 cases had no effusion,56 cases had 1st degree effusion,and 95 cases had 2nd degree effusion in the cochlea.(i)There was a significant difference between the site of lymphatic effusion in the affected ear and the degree of hearing loss(P<0.05).(ii)There was a positive correlation between the degree of vestibular and cochlear fluid accumulation and the degree of hearing loss in patients(P<0.05),with more significant hearing loss in low and medium frequencies.(iii)There was a positive correlation between the degree of cochlear effusion and EcochG results,and between the degree of vestibular effusion and c-VEMP results(P<0.05).(iv)There was no correlation between patient’s age,duration of vertigo during episodes and the degree of endolymphatic effusion(P>0.05),and there was a correlation between the duration of vertigo and the degree of endolymphatic effusion(P<0.05).ConclusionThere is a positive correlation between the degree of endolymphatic hydrops and hearing loss in the affected ear,and controlling the progression of endolymphatic hydrops may improve the patient’s hearing status to some extent.The combination of endolymphatic hydrops on MRI and other auditory-vestibular function tests can assist in the clinical assessment of MD disease staging and the selection of more effective treatment options.