中文摘要：

目的对梅尼埃病（Meniere’sdisease）患者采用经鼓膜穿刺鼓室内注入对比剂钆、内耳三维快速液体衰减反转恢复磁共振（three—dimensionalfluid—attenuatedinversionrecoverymagneticresonanceimaging，3D—FLAIRMRI）扫描，将影像学显示的膜迷路积水情况与临床听力及前庭功能检查结果进行比较，探讨经鼓室钆注射内耳成像磁共振在梅尼埃病诊断中的应用价值。方法32例经临床确诊的单侧梅尼埃病患者，双侧耳均经鼓膜穿刺鼓室内注入对比剂钆喷酸葡胺稀释液，24h后行3D—FLAIRMRI和三维平衡快速梯度回波磁共振扫描，观察双侧耳蜗、前庭和半规管外淋巴间隙的增强显影，对耳蜗底转鼓阶和前庭阶分别进行评分，并对前庭外淋巴间隙显影范围进行测量。患者常规行纯音测听、冷热试验、前庭诱发肌源性电位（vestibularevokedmyogenicpotential，VEMP）和耳蜗电图检查。将患侧耳蜗底转前庭阶评分及前庭外淋巴间隙显影范围分别按纯音测听、冷热试验、VEMP、耳蜗电图的检查结果分组进行比较，采用SPSSl7．0统计软件进行数据分析。结果全部患者内耳3D—FLAIRMRI均显示对比剂钆广泛分布于耳蜗、前庭和半规管的外淋巴间隙，可清晰对比显示内淋巴间隙。患侧耳蜗底转前庭阶评分值与健侧比较，差异具有统计学意义（Z=4．309，P〈0．05）；患侧与健侧前庭外淋巴间隙显影范围（x±s）分别为（6．04±2．89）mm2和（8．28±3．04）mm2，二者比较差异具有统计学意义（t=3．322，P〈0．05）。VEMP异常组患者与VEMP正常组比较，患侧前庭显影范围明显缩小，差异具有统计学意义（F=11．96，P〈0．05）。耳蜗电图异常组患者与正常组比较，耳蜗底转前庭阶评分明显偏低，差异具有统计学意义（Z=3．17，P〈0．05）。患侧耳蜗前庭阶评分及前庭显影范围与患者听力水平及冷热试验结果无明显相关?

英文摘要：

Objective To study the feasibility of endolymphatic visualization and the diagnosis of Meniere＇s disease by applying intratympanic gadolinium adminstration through the tympanic membrance and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging （3D-FLAIR MRI）. To study the relationship between the endolymphatic hydrops visualized by MRI and audio-vestibular functional tests, such as pure tone audiometry （PTA）, electrocochleography （EcoG）, caloric test and vestibular evoked myogenic potential （VEMP）. Methods With a three Tesla magnetic resonance imaging （MRI） unit, 3D-FLAIR imaging was performed 24 hours after intratympanic gadolinium through the tympanic membranee in 32 patients with clinically diagnosed unilateral Meniere＇s Disease. We visualized the enhanced imaging of perilymphatie space in bilateral cochlea, vestibular and （or） canal, scoring scala tympani andscala vestibule of bilateral cochlear basal turn respectively and measuring the developing area of bilateral vestibule and the signal intensity ratio （SIR） between the vestibule and the brain stem subjectively. PTA, EcoG, caloric test and VEMP were performed. The relationship between the endolymphatic hydrops visualized by MRI and audio-vestibular functional tests were studied. Results The gadolinium appeared in almost all parts of the perilymph in cochlea, vestibular and （or） canals in all 32 patients＇ inner ears, so the endolymphatic space was clearly shown on 3D-FLAIR imaging. The scala vestibuli score value between the affected side and the healthy side were statistically significant （ Z = 4. 309, P 〈 0. 05 ）. The developing vestibular area between the affected side and the healthy side [ （6. 04 ± 2. 89 ）mm2, （ 8.28 ± 3.04 ）mm2 ] were statistically significant （ t = 3. 322, P 〈 0. 05 ）. Abnormal vestibular evoked myogenic potentials were significantly correlated with the developing vestibular area of the affected side （ F = 11.96, P 〈 0. 05 ）. Abnormal electr