Relevant Research Of Endolymphatic Imaging And Clinical Manifestations In Meniere's Patients

Objective:In recent years,endolymphatic imaging has been progressing rapidly.And the administration methods are various,which contain local administration and intravenous administration.Many institutions reported different evaluative standards for endolymphatic hydrops.And now,researches on endolymphatic imaging are more and more advanced.Much more clinical institutions published their study about relationships of endolymphatic imaging and clinical examinations,such as electrocochleography(EcochG),vestibular-evoked myogenic potential(VEMP),caloric test and glycerol test.However,there is no relevant study about different periods of Meniere's disease and endolymphatic imaging.This research aimed to study the relationship of endolymphatic imaging and clinical manifestations(duration of last attack period to MRI scan)of Meniere's patients.Method:26 Meniere's patients and 29 affected ears in total were enrolled in this research.According to clinical manifestations,when performing MRI scan,patients who were not in attack period and the duration of last attach period to MRI scan was longer than 14 days were divided to Group A;and patients who were in attack period or the duration of last attach period to MRI scan was shorter than or equal to 14 days were divided to Group B.Administrate gadolinium to mid-ear affected by MD through Eustachian tube,and then perform 3D-FLAIR MRI scan afer one day.After measurement and calculation,compare RV and RC(area of endolymphatic space divided by total lymphatic space in vestibule and cochlea,respectively)of the two groups.ANOVA test was utilized in this research.Results:29 affected ears of 26 patients were administrated successfully.The endolymphatic spaces were distinct from perilymphatic spaces in vestibule and cochlea in 26 ears.In the images of B6,B12,B14,the cochlea and semicircular canals were enhanced,but the vestibules were not enhanced.For Group A,the average of RV was 0.37,and the standard deviation was 0.06;the average of RC was 0.15,and the standard deviation was 0.04.As to Group B,the average of RV was 0.52,and the standard deviation was 0.26;the average of RC was 0.18,and the standard deviation was 0.06.According to ANOVA test,RV of the two group had significant difference(p<0.05),RC had no significant difference(p>0.05).The positive RC and RV in Group A were 7.1%and 42.9%respectively.The positive RC and RV in Group B were 13.3%and 66.7%,respectively.As to 4 patients who were during attack period in Group B,the positive RC and RV were 50%and 100%,respectively.The positive RV of Group B was higher than that of Group A.Conclusion:The clinical manifestations(duration of last attack period to MRI scan)of Meniere's patients had relationship with positive rate of MRI scan.The possibility of positive RV was higher when the duration of attack period to MRI scan was shorter.The diagnosis standard for endolymphatic hydrops in vestibule should be revised as following:ratio of endolymphatic space in vestibule(area of endolymphatic space devided by that of total lymphatic space)?39%indicates endolymphatic hydrops in vestibule;and when the perilymphatic spaces of cochlea and semicircular canals are enhanced,but the perilymphatic space of vestibule is not enhanced,it indicates extremely endolymphatic hydrops in vestibule.