Clinical Significance Of Inner Ear Imaging After Intratympanic Gadolinium Injection In The Diagnosis Of Meniere’s Disease

Objective: By comparing the difference of positive rate in the diagnosis of endolymphatic hydrops in patients with Meniere’s disease by inner ear imaging after intratympanic gadolinium injection,glycerol test and electrocochleogram,discussed the clinical significance of inner ear imaging after intratympanic gadolinium injection in the diagnosis of Meniere’s disease.Methods: From August 2019 to March 2021,34 cases of Meniere’s disease were admitted in the Department of Otolaryngology Head and Neck Surgery of our hospital,Three of them were bilateral Meniere’s disease,total 37 ears,After24 hours of intratympanic gadolinium injection and conduct 3D-FLAIR MRI of examination,cochlear endolymphatic hydrops is divided into II levels according to the shape of the low signal region between the vestibular canal and tympanic canal;vestibular endolymphatic hydrops is divided into III levels according to the size of the area vestibular saccularis and alveus communis.And conduct glycerol test,electrocochleogram.All affected ears complete the above examination within one week of the last vertigo,compare the positive rate of the above examination results;according to the average hearing threshold of0.5k Hz、1k Hz、2k Hz pure tone in the intermission of 6 months,the stage of Meniere’s disease was determined.To analyze the correlation between age,duration of disease,pure tone threshold,stage of Meniere’s disease and the degree of endolymphatic hydrops in cochlea and vestibular,to evaluate the advantages of inner ear imaging after intratympanic gadolinium injection in the diagnosis of endolymphatic hydrops.Results:All the patients underwent inner ear imaging after intratympanic gadolinium injection with clear development,and no ear pain,purulent ear discharge and other symptoms within a week,the tympanic membrane healed well.37 cases were examined by inner ear imaging after intratympanic gadolinium injection,positive 35 ears,negative 2 ears,the positive rate of inner ear imaging after intratympanic gadolinium injection was 94.6%;glycerol test for 37 ears,positive 22 ears,negative 15 ears,the positive rate of glycerol test was59.5%;electrocochleogram for 37 ears,three of them didn’t come out,the 34 ear come out,positive 22 ears,negative 12 ears,the positive rate of electrocochleogram was 64.7%.By statistical analysis,the positive rate of inner ear imaging after intratympanic gadolinium injection in patients with Meniere’s disease was higher than glycerol test and electrocochleogram(P<0.017).The degree of cochlear and vestibular endolymphatic hydrops in 37 affected ears was evaluated according to the results of inner ear imaging after intratympanic gadolinium injection,cochlea without endolymphatic hydrops 5ears,I grade endolymphatic hydrops 13 ears,II grade endolymphatic hydrops 19ears;Vestibule without endolymphatic hydrops 4 ears,I grade endolymphatic hydrops 13 ears,II grade endolymphatic hydrops 11 ears,III grade endolymphatic hydrops 19 ears.Stages of Meniere’s disease in 37 ears:6 ears in one stage,5 ears in two stage,15 ears in three stage,11 ears in four stage.Cochlear endolymphatic hydrops and vestibular endolymphatic hydrops showed moderate positive correlation with pure tone hearing threshold(cochlear endolymphatic hydrops and pure tone hearing threshold:r=0.690,P<0.001;vestibular endolymphatic hydrops and pure tone hearing threshold:r=0.571,P<0.001);cochlear and vestibular endolymphatic hydrops were moderate positively correlated with the stage of Meniere’s disease(cochlear endolymphatic hydrops and Meniere’s disease stage:r=0.664,P<0.001;vestibular endolymphatic hydrops and Meniere’s disease stage:r=0.515,P=0.001);had no correlation with age,duration of disease,glycerol test results,electrocochleogram results(P>0.050).Conclusion: Inner ear imaging after intratympanic gadolinium injection can not only diagnose endolymphatic hydrops in patients with Meniere’s disease,but also location and degree of endolymphatic hydrops in Meniere’s disease.Its development effect is good and suitable for clinical development.The positive rate of inner ear imaging after intratympanic gadolinium injection diagnose endolymphatic hydrops in Meniere’s disease is higher than that in glycerol test and electrocochleogram.Moreover,the location and degree of endolymphatic hydrops can be used to evaluate the stage of Meniere’s disease,which is of positive significance to the subsequent treatment of patients.