Contrast Agent Uptake in Endolymphatic Sac and Duct: Inverse Relation to Endolymphatic Hydrops.

IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Laryngoscope Pub Date : 2025-03-19 DOI:10.1002/lary.32127
Johannes Gerb, Emilie Kierig, Valerie Kirsch, Sandra Becker-Bense, Rainer Boegle, Thomas Brandt, Marianne Dieterich
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引用次数: 0

Abstract

Objectives: Ménière's disease (MD) and vestibular migraine (VM) can be associated with endolymphatic hydrops (ELH). The differential role of the endolymphatic sac and duct (ES/ED) system for the development of ELH is poorly understood.

Methods: On 251 delayed, contrast-enhanced inner ear MRI (iMRI) datasets from neurotological patients and healthy control participants, we evaluated (1) the visibility of the ES/ED system using a novel semi-quantitative scale, and (2) the dimensions of ELH, calculated using volumetric local thresholding (VOLT). Afterwards, statistical analysis of ES/ED radiologic visibility in relation to the grade of ELH, the degree of clinical symptoms, and audiometric findings was performed.

Results: Patients were divided into an MD cohort (n = 68, 34 females, mean age 54.5 ± 14.8 years) and a VM cohort (n = 67, 42 females, 45.9 ± 15.5 years). The remaining datasets did not fulfill diagnostic criteria for definite diagnoses (n = 64, 27 females, mean age 51.3 ± 16.6) or were from healthy controls (HC; n = 52, 27 females, 49.0 ± 18.1 years). MD patients showed the lowest ES/ED-visibility scores on the affected side (ANOVA F(172,2): 20.60, p < 0.001), while the ES/ED-visibility on the non-affected side in MD patients was still significantly lower than in VM and HC (ANOVA F(172,2): 6.80, p 1.44 × 10-3). The ES/ED-visibility score and ELH volume (determined by VOLT, in mm3) correlated inversely (Spearman's rho: -0.32, Fisher's z -0.34, p < 0.001).

Conclusion: ES/ED radiologic visibility in iMRI is inversely associated with ELH volumes. Patients with MD show substantially decreased ES/ED visibility on the affected ear and (less pronounced) on the unaffected ear, while VM and HC exhibit normal ES/ED visibility.

Level of evidence: 3:

内淋巴囊和导管内造影剂摄取:与内淋巴水肿呈反比关系。
目的:颈椎病(MD)和前庭偏头痛(VM)可与内淋巴积液(ELH)相关。内淋巴囊和导管(ES/ED)系统在ELH发展中的不同作用尚不清楚。方法:对来自神经学患者和健康对照者的251个延迟,对比增强的内耳MRI (iMRI)数据集进行评估(1)使用新的半定量量表评估ES/ED系统的可见性,(2)使用体积局部阈值(VOLT)计算ELH的维度。随后,统计分析ES/ED放射学可视性与ELH分级、临床症状程度和听力学结果的关系。结果:患者分为MD组(n = 68, 34名女性,平均年龄54.5±14.8岁)和VM组(n = 67, 42名女性,45.9±15.5岁)。其余数据集不符合明确诊断的诊断标准(n = 64, 27名女性,平均年龄51.3±16.6)或来自健康对照(HC;N = 52,女性27例,年龄49.0±18.1岁)。MD患者患侧ES/ ed可见度评分最低(方差分析F(172,2): 20.60, p -3)。ES/ED可见度评分与ELH体积(由VOLT决定,单位为mm3)呈负相关(Spearman’s rho: -0.32, Fisher’s z -0.34, p)结论:iMRI ES/ED放射学可见度与ELH体积呈负相关。MD患者在受影响的耳朵和未受影响的耳朵(不太明显)表现出明显的ES/ED可见度下降,而VM和HC表现出正常的ES/ED可见度。证据等级:3;
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来源期刊
Laryngoscope
Laryngoscope 医学-耳鼻喉科学
CiteScore
6.50
自引率
7.70%
发文量
500
审稿时长
2-4 weeks
期刊介绍: The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects
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