Application Of Gadolinium-Enhanced Magnetic Resonance Imaging Of Inner Ear In The Diagnosis Of Meniere’s Disease

Objective To evaluate the application of gadolinium-enhanced magnetic resonance imaging of inner ear in the diagnosis of Meniere’s disease.Methods After pure tone audiometry,cochlear electrogram and cervical vestibular evoked myogenic potential(c VEMP)test,bilateral intratympanic injection of gadolinium was performed,and three dimensional fluid inversion recovery(3D-FLAIR)scan was performed 24 hours later.Evaluated the locations and severity of the vestibule,semicircular canal and cochlea.And compared with other examination results and clinical symptoms.Study the application of gadolinium contrast MRI in the diagnosis of Meniere’s disease.Results The endolymphatic spaces were distinct from perilymphatic spaces in 37 ear of the affected side,36 cases(97.2%)were diagnosed as Endolymphatic hydrops.The semicircular canal had less endolymphatic hydrops than the cochlea and vestibule.The lateral semicircular canal had less endolymphatic hydrops than the superior semicircular canal and the posterior semicircular canal.The endolymphatic spaces were distinct from perilymphatic spaces in 38 ear of the contralateral ear.15 cases(39.5%)were diagnosed as endolymphatic hydrops,14 of which were bilateral hydrops(37.8%).There was no significant difference in age and low frequency average hearing threshold between patients with bilateral endolymphatic hydrops and patients with unilateral endolymphatic hydrops.Patients with bilateral endolymphatic hydrops have a longer course of disease.The positive rate of gadolinium-enhanced MRI was higher than that of electrocochleogram SP / AP amplitude ratio(28.6%),SP / AP area ratio(45.7%)and vestibular evoked myogenic potential(51.6%),and the difference was statistically significant(P < 0.05).There was no significant correlation between the score of gadolinium-enhanced MRI and the asymmetry ratio of c VEMP,the amplitude ratio of SP / AP,the area ratio of SP / AP,the age,the course of disease and the low frequency average hearing threshold(P > 0.05)Conclusion 1.Gadolinium-enhanced MRI of inner ear has a high positive rate in the diagnosis of endolymphatic hydrops in Meniere’s disease.It is more difficult for MD patients to have endolymphatic hydrops in semicircular canal than in vestibule and cochlea;2.Some patients with unilateral Meniere’s disease are also have endolymphatic hydrops on the opposite side,which is related to the course of disease;...