Quantitative study of vestibular endolymphatic hydrops in Meniere’s disease based on Three-Dimensional real Inversion Recovery (3D-real IR) sequence

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-08-25 DOI:10.1016/j.ejrad.2025.112382

Jiajia Zhao , Mengqiu Liu , Siqi Sun , Ruirui Guan , Ying Liu

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引用次数: 0

Abstract

Objective

To establish objective criteria for grading vestibular endolymphatic hydrops (EH) in Meniere’s disease (MD) using 3D-real IR MRI, and investigate its clinical correlations.

Methods

Retrospective analysis of 155 MD patients (189 ears) included clinical data, audiovestibular assessments, and gadolinium-enhanced MRI. Vestibule volume (VV) and the volume of vestibular endolymph (EndV) were outlined on 3D-real IR sequence images, and the volume of vestibular endolymph was calculated by the vestibular endolymphatic ratio (ELR) to evaluate the degree of EH, analyze the correlation between the degree of EH and specific clinical features, hearing and vestibular function, and determine the optimal ELR value to differentiate each degree of effusion by using receiver operating characteristic (ROC) curve analysis.

Results

EH severity significantly correlated with disease stage (P < 0.001), pure-tone average (P < 0.001), age (P < 0.01), and caloric weakness (P < 0.01), but not with gender, disease duration, vertigo frequency, tinnitus, aural fullness, or electrocochleography. Affected ears demonstrated significantly different EndV (0.013 ± 0.003 vs 0.005 ± 0.001 cm³) and ELR (33.6 ± 12.1 % vs 6.4 ± 2.7 %) compared to controls (P < 0.01), while maintaining comparable VV (0.08 ± 0.016 cm³). ROC analysis established ELR thresholds of 16 % (AUC = 0.905), 34 % (AUC = 0.871), and 47 % (AUC = 0.899) differentiating no hydrops from grade I, grade I from II, and grade II from III, respectively.

Conclusion

3D-real IR MRI enables quantitative EH assessment, with ELR thresholds providing objective grading criteria. EH severity reflects pathophysiological progression through its associations with auditory/vestibular dysfunction and disease stage, while demonstrating stability of total vestibular volume. This methodology addresses limitations of subjective grading systems, offering standardized metrics for clinical research and therapeutic monitoring.

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基于三维真实反转恢复（3D-real IR）序列的梅尼埃病前庭内淋巴积液定量研究

目的应用3D-real IR MRI建立门静脉内淋巴积液（EH）分级的客观标准，探讨其临床相关性。方法回顾性分析155例MD患者（189耳）的临床资料、听庭评估和钆增强MRI。在3D-real IR序列图像上勾勒出前庭体积（VV）和前庭内淋巴体积（EndV），通过前庭内淋巴比（ELR）计算前庭内淋巴体积，评估EH程度，分析EH程度与特定临床特征、听力和前庭功能的相关性，并通过受试者工作特征（ROC）曲线分析确定区分各程度渗出的最佳ELR值。结果h严重程度与疾病分期（P < 0.001）、纯音平均值（P < 0.001）、年龄（P < 0.01）、热无力（P < 0.01）相关，与性别、病程、眩晕频率、耳鸣、耳廓充盈、耳蜗电图无显著相关性。与对照组相比，患耳的EndV（0.013±0.003 vs 0.005±0.001 cm3）和ELR（33.6±12.1% vs 6.4±2.7%）差异显著（P < 0.01），而VV保持相当（0.08±0.016 cm3）。ROC分析确定无积水与I级、I级与II级、II级与III级的ELR阈值分别为16% （AUC = 0.905）、34% （AUC = 0.871）和47% （AUC = 0.899）。结论3d -real IR MRI能够定量评价EH， ELR阈值提供客观分级标准。EH严重程度通过与听觉/前庭功能障碍和疾病分期的关系反映病理生理进展，同时显示前庭总容积的稳定性。这种方法解决了主观评分系统的局限性，为临床研究和治疗监测提供了标准化的指标。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.