The Clinical Correlation Of MRI Findings Of Endolymphatic Hydrops In Meniere’s Disease

Objective:We can explore the application value of gadolinium contrast MRI in the diagnosis and treatment of Meniere’s disease,and analyze the correlation between the degree of endolymphatic hydrops and its clinical manifestations in patients with Meniere’s disease through applying the gadolinium contrast MRI of inner ear.Methods:From October 2019 to October 2020,122 patients with Meniere’s disease diagnosed in vertigo clinic of the department of Otorhinolaryngology,the second hospital of Jilin University were collected.After pure tone audiometry,all patients underwent gadolinium contrast MRI examination of inner ear,and tinnitus patients underwent tinnitus matching test.The gadolinium contrast MRI was performed 4hours after intravenous injection of double dose gadobutanol.Two experienced radiologists used a double-blind method to evaluate the degree of endolymphatic hydrops on MRI images of 122 patients by using Bernaerts’ visual scoring method.According to the location of endolymphatic hydrops,patients with Meniere’s disease can be divided into vestibular group,cochlear group and vestibular + cochlear group.The air conduction thresholds of 500 Hz,1k Hz and 2KHz in pure tone audiometry were taken to calculate the average hearing threshold.The results were divided into four stages according to the staging standard of Meniere’s disease,i.e.stage 1,stage 2,stage 3 and stage 4.Stage 1 and stage 2 are classified as group A,and stage 3 and stage 4 were classified as group B.The results of tone matching in tinnitus matching test were divided into four groups according to their frequency characteristics: normal group,low frequency group(frequency ≤250Hz),medium frequency group(frequency: 500～2khz)and high frequency group(frequency ≥ 4k Hz).1.SPSS 26.0 software was used to test the significance of the location of endolymphatic hydrops with the degree of hearing loss and tinnitus frequency of the affected ear by chi square test,so as to determine whether the location of endolymphatic hydrops will affect the degree of hearing loss and tinnitus frequency.2.Spearman rank correlation analysis was used to analyze the relationship between the degree of endolymphatic hydrops and the average hearing threshold.Results:1.In this study,the positive rate of gadolinium contrast MRI in detecting endolymphatic hydrops in patients with Meniere’s disease was 97.5%;the average hearing threshold of patients with Meniere’s disease in vestibular group and vestibular+ cochlear group was more common in three and four stages.2.There was significant difference between the location of endolymphatic hydrops and the degree of hearing loss(P = 0.000).3.There was no significant difference between the location of endolymphatic hydrops and the tinnitus frequency(P = 0.263).4.The average hearing threshold of the affected ear was significantly correlated with the degree of cochlear hydrops(R = 0.303,P=0.008)and the degree of vestibular hydrops(R = 0.461,P=0.000).Conclusions:1.Gadolinium contrast MRI of inner ear after intravenous injection of gadolinium can show endolymphatic hydrops in patients with Meniere’s disease,which provides imaging basis for the diagnosis of Meniere’s disease.2.Gadolinium contrast MRI of inner ear can evaluate the severity of endolymphatic hydrops in patients with Meniere’s disease,and the degree of endolymphatic hydrops is related to the degree of hearing loss in patients with Meniere’s disease.