| Objection:We used the three-dimensional fluidattenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) technology which endolymphatic hydrops in both the cochlea and the vestibule by applying noninvasive intratympanic gadolinium (Gd) perfusion through eustachian tub,Based on the normal lymph MRI imaging of the inner ear,we measured the inner ear lymph sectional areas in line with the objective and unite criterion and discussed whether this method could be used to evaluate the controlled clinical research is scientific accuracy and feasibility.Methods:There were 12 healthy adults in this study and they were randomly devided into group A and group B. A group have 6 people and B was 6 people.Under observation of auricular endoscope in acoustic duct, we administrated diluted gadopentetic acid to group A and B and performed the three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging(3D-FLAIR MRI) on 3 tesla MR machine 24 hours later. A was performed in Tong Ren hospital and B was in Bei Jin hospital.The brand of the MRI in Tong Ren hospital is GE(HDX, American) and Bei Jin hospital is PHILIPS(ACHIEVA, Netherlands).In the cochlea, the sectional area of the endolymphatic space and the fluid space (sum of the endolymphatic and perilymphatic space) was measured on images of paralleled modiolus cochlea. In the vestibule, the sectional area of the endolymphatic space (sum of the utricle and saccule) apd the fluid space (sum of the endolymphatic and perilymphatic spaces) was measured on images of paralleled longitudinal axis of vestibule.We also performed pure-tone audiometric testing and acoustic impedance audiometry after a week and a month.Results:1.In the period of administration,there was transient painful sensory in all of the 12 subjects when installing catheter into eustachian tube.Transient rotatory dizziness happened in 4 of the 12 subjects,fullness in ear happened in 3 subjects,tinnitus which sound like flowing water happened in 6 subjects.Cough happened in 1 subject.All of the symptoms disappeared in 5 minutes after administration.2.12 healthy volunteers divided into two groups,A is 6 and B is 6, the gadolinium could appear in parts of the perilymph inside the inner ear, moreover, the border between the perilymph and endolymph was visible so that endolymphatic space was clearly shown on 3D-FLAIR imaging.3. the ratios of the area of the endolymphatic space to that of the fluid space in the cochlea and the vestibule were 0.19±0.04 and 0.15±0.03 in A group and B group were 0.31±0.06 and 0.32±0.05, moreover, the changes of the ratios of the area of the endolymphatic space to that of the fluid space in the cochlea and vestibular between A and B 12 healthy volunteers have no statistically significant (P>0.05)4. We followed up 12 subjects after a month,the results of pure-tone audiometric testing and acoustic impedance audiometry were normal,and had no significant differences to those examined before administration.Conclusion:The endolymphatic space measurements by applying non-invasive intratympanic gadolinium (Gd) perfusion through eustachian tube and 3D-FLAIR MRI and adopted the objective and unite criterion of the lymph MRI imaging of the inner ear are scientific,accuracy and feasibility.It can be used widely in clinical control study.This research laid the necessary foundation and diagnosis and treatment guideline for the advanced research of the endolymphatic hydrops of inner ear disease which the main pathological feature is endolymphatic hydrops of inner ear. The objective assessment of the normal inner ear endolymphatic space measurement through 3D-FLAIR MRI provide the basis for Correlative studies of the evaluation of the degree of endolymphatic hydrops and the severity of clinical symptoms. |
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