内耳影像学 应用内淋巴积水成像进行梅尼埃病分类TsutomuNAKASHIMA,IlmariPYYKK?,MichihikoSONE,MasaakiTERANISHI, TadaoYOSHIDA,TakafumiNAKADA,KyokoMORIMOTO,ShinjiNAGANAWA 日本,名古屋大学医学研究生院,耳鼻咽喉头颈外科,放射科;日本,一宫治疗康复中心,康复科;芬兰,坦佩雷大学,耳鼻咽喉头颈外科;日本,医院,耳鼻咽喉头颈外科 背景:新的梅尼埃病标准于年发布于前庭研究杂志。新的标准包括确诊梅尼埃病和疑似梅尼埃病,但是排除了潜在的梅尼埃病,可能的梅尼埃病和交界的梅尼埃病或梅尼埃病初期应该被进一步探讨。 患者:对例的可能潜在性、可能性或限定性梅尼埃病、非典型梅尼埃病或者其他疾病包括偏头痛相关性眩晕的病人进行静脉或鼓室内注射钆对比剂行3T核磁检查,从而评估耳蜗及前庭内淋巴的空间大小。 结果:几乎所有按美国耳鼻咽喉头颈外科学会定义确诊梅尼埃病和疑似梅尼埃病的病人均有耳蜗及前庭的内淋巴积水。在确诊梅尼埃病的病人中或者存在耳蜗内淋巴积水,或者存在前庭内淋巴积水。按美国眼耳鼻喉科学会年定义的前庭型梅尼埃病病人存在前庭内淋巴积水,相反大多数偏头痛相关性眩晕病人没有前庭内淋巴积水。单耳确诊梅尼埃病的病人健耳通常存在无症状的轻度或显著内淋巴积水。 结论:当核磁无法检查出内淋巴积水,应重新考虑诊断梅尼埃病。当许多非典型病例出现内淋巴积水时,诊断为梅尼埃病应包括耳蜗型梅尼埃病和前庭型梅尼埃病。应用内淋巴水成像对于梅尼埃病分类(非梅尼埃病标准)或许是有用的。 TheInnerEarImaging CLASSIFICATIONOFMENIERE’SDISEASEWITHUSEOFENDOLYMPHATICHYDROPSIMAGING TsutomuNAKASHIMA1,2,IlmariPYYKK?3,MichihikoSONE1,MasaakiTERANISHI1,TadaoYOSHIDA1, TakafumiNAKADA1,4,KyokoMORIMOTO1,ShinjiNAGANAWA5 1DepartmentofOtorhinolaryngology,NagoyaUniversityGraduateSchoolofMedicine,Japan 2DepartmentofRehabilitation,IchinomiyaMedicalTreatmentHabilitationCenter,Japan 3DepartmentofOto-laryngology,UniversityofTampere,Finland 4DepartmentofOtorhinolaryngology,GifuPrefecturalTajimiHospital,Japan 5DepartmentofRadiology,NagoyaUniversityGraduateSchoolofMedicine,Japan Background:AnewcriteriaofMeniere’sdisease(MD)waspublishedinJournalofVestibularResearchin.ThenewcriteriaincludeddefiniteMDandprobableMDbutexcludedpossibleMD.PossibleMD,borderlineMDorinitialstageofMDshouldbeinvestigated. Methods:Endolymphaticspacesizeinthecochleaandthevestibulewasevaluatedwith3TMRIafterintravenousorintratympanicinjectionofgadoliniumcontrastagentsin1,patientswithtypicalMD,atypicalMDorotherdiseasesincludingmigraineassociatedvertigo. Results:AlmostallearswithdefiniteandprobableMDdefinedbyAAO-HNShadendolymphatichydrops(EH)inboththecochleaandthevestibule.EithercochlearEHorvestibularEHwasobservedinallearswithdefiniteMD.IncontrasttovestibularMDthatwasdefinedbyAAOOinhadvestibularEH,novestibularEHwasobservedinthemajorityofpatientswithmigraineassociatedvertigo.AsymptomaticmildorsignificantEHwasfrequentlyobservedonnon-affectedsideinpatientswithunilateraldefiniteMD. Conclusion:WhenEHisnotobservedatallonMRI,diagnosisofMDshouldbereconsidered.CochlearMDandvestibularMDshouldbeincludedinthediagnosisofMDasEHhasbeenobservedinmanyatypicalcases.ClassificationofMD(notcriteriaofMD)withuseofEHimagingmaybeuseful. 本文版权归中国医药教育协会眩晕专业委员会所有,欢迎转发,禁止复制转载!如有转载需求,请联系专委会办公室-。 长按权威白癜风医院权威白癜风医院
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