The Clinical And Basic Research Of Gadolinuim-enhanced Inner-ear For Meniere's Disease

Part one:The Research of Gadolinuim-enhanced Inner-ear for Inner Ear Imaging and the Diagnosis of Meniere's DiseaseObjective:To study the correlation between the degree of endolymphatic shown by gadolinuim-enhanced inner-ear MRI in patients with Meniere's disease and the clinical manifestations and results of auditory-vestibular function tests.Methods:From October 2018 to November 2019,24 patients with MD were diagnosed in the Affiliated Hospital of North Sichuan Medical College,22 cases were unilateral,2 cases were bilateral,and 26 sick ears in total.Accomplishing the pure tone hearing threshold,ECochG and c-VEMP.3D-FLAIR MRI scanning were performed 24 hours after intratympanic injection of gadolinuim.Evaluate the degree of endolymphatic hydrops(EH)in the vestibule and cochlea,and analyze the correlation between the degree of EH with symptoms and results of auditory-vestibular function tests.Results:Different degree of EH were observed in all 26 sick ears.There was a significantly correlation between the degree of EH in the vestibule and the cochlea(P=0.025).Pure tone hearing threshold was significantly correlated with both the vestibular EH(P=0.011)and cochlear EH(P=0.003).There was a positive correlation between the ECochG and cochlear EH(P=0.019),but the vestibular EH(P=0.078>0.05).c-VEMP was significantly correlated with the vestibular EH(P=0.026),but the cochlear EH(P=0.228>0.05).There was no correlation between the age,the duration of the disease,the frequency of dizziness,tinnitus and aural fullness with the degree of cochlear and vestibular EH(P>0.05).Conclusion:Gadolinuim-enhancedinner-ear can visualize endolymphatic hydrops.The degree of endolymphatic hydrops can reflect hearing loss.The degree of cochlear EH is significantly correlated with the ECochG,the degree of vestibular EH is significantly correlated with the VEMP.Suggesting that MRI of gadolinuim-enhanced inner-ear can not only help the diagnosis of MD,can also assess the level of inner ear function in MD.Part two:In Vivo of Inner Ear of Normal Guinea Pig after Postaurical Injecting gadoliniumwith MRIObjective:To study the inner ear of normal guinea pig after postaurical injecting gadoliniumwith MRI,observe the distribution of gadolinium in the inner ear,and explore a new approach to the route of gadolinium.Methods:12 male guinea pigs were randomly divided into 3 groups,including a control group,a tympanic injection group and a postaurical injection group,with 4 guinea pigs per group.The control group was postaurical injected with normal saline of the two ears,the tympanic injection group was tympanic injected with gadolinium in two ears,and the postaurical injection group was postaurical injected with gadolinium in two ears.After 24 hours,MRI scans of FIESTA and 3D-FLAIR sequences were performed to observe the inner ear enhancement characteristics of magnetic resonance imaging.Results:The FIESTA sequence of three groups could not distinguish the endolymph and perilymph of Inner Ear.In the 3D-FLAIR sequence,the control group,the cochlea and vestibule were not developed.In the tympanic injection group,gadoliniumwas entered into the vestibule and cochlea,which could distinguish the endolymph and perilymph.gadolinium was also entered into the vestibule and cochlea of the postaurical injection group,and internal and external lymphatics could be distinguished,and there was no significant difference between the two groups of images.Conclusion:The gadolinium can entere into the perilymph after Postaurical Injecting it.The 3D-FLAIR sequence magnetic resonance imaging can distinguish the space of endolymph and perilymph.Postaurical Injecting gadolinium may be another route of administration for MRI scan of inner ear,and providing experimental basis for clinical research.