地塞米松在24小时内不会影响梅尼埃病患者的内淋巴水肿(EH),并且使用7分钟的新方案在鼓腔内给药钆加地塞米松简化了EH的高质量成像

IF 1.4 Q2 OTORHINOLARYNGOLOGY
Jing Zou , Zikai Zhao , Hongbin Li , Guoping Zhang , Qing Zhang , Jianping Lu , Ilmari Pyykkö
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引用次数: 2

摘要

背景:与静脉注射相比,在鼓室内给药螯合钆可以更好地使用MRI显示内淋巴水肿(EH),最近进一步改进,可以在7分钟内获得高质量的EH成像。本研究的目的是通过将螯合钆与治疗性地塞米松混合来简化鼓室内给药方案,并评估这种混合物对EH在MRI中显示的影响。材料与方法在体外研究中,采用高效液相色谱法分析钆-二乙烯三胺五乙酸(Gd-DTPA)与地塞米松混合后的动态变化,评价钆-二乙烯三胺五乙酸(Gd-DTPA)对地塞米松稳定性的潜在影响。选取10例确诊的梅尼埃病(MD)患者,研究地塞米松对EH MRI可视化的潜在干扰;选取49例MD患者,采用3T磁共振成形仪和全新的重t2加权的三维液体衰减反演恢复(hT2FLAIR-MZFI)序列重建,评价鼓腔内注射Gd-DTPA混合地塞米松对EH MRI的影响。结果Gd-DTPA的加入对地塞米松的HPLC保留时间和峰面积没有影响。鼓室内注射地塞米松对耳蜗和前庭的EH分级无影响。所有患者均获得良好的内耳图像,并显示不同级别的EHs。诊断与耳蜗EH有显著相关性(p <0.01, Spearman’s Rho),诊断与前庭EH之间的差异(p <0.01, Spearman’s Rho),耳蜗与前庭EH之间差异有统计学意义(p <0.01,斯皮尔曼Rho)。Gd-DTPA加地塞米松的分布与前庭EH的分级呈负相关。59例MD内耳患者的1个耳蜗和3个前庭均可见到内淋巴-淋巴周围屏障的损伤。结论经鼓室给药Gd-DTPA联合地塞米松可获得高质量的EH MRI图像,采用新颖的7分钟方案,简化了临床应用。在今后的工作中,Gd-DTPA联合地塞米松可用于检测其治疗效果。证据水平3。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min

Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min

Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min

Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min

Background

Intratympanic administration of gadolinium chelate allows for a better visualization of endolymphatic hydrops (EH) using MRI than intravenous injection and was recently further improved to facilitate high-quality imaging of EH in 7 min. The aim of the present study was to simplify the intratympanic administration protocol by mixing gadolinium chelate with therapeutic dexamethasone and to evaluate the effects of this mixture on the visualization of EH in MRI.

Materials and methods

In an in vitro study, the potential impact of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) on the stability of dexamethasone was evaluated by analyzing dynamic changes in dexamethasone with high-performance liquid chromatography (HPLC) after mixing with Gd-DTPA. Ten patients with definite Meniere's disease (MD) were recruited to study the potential interference of dexamethasone on MRI visualization of EH, and 49 patients with MD were recruited to evaluate the effect of intratympanic injection of Gd-DTPA mixed with dexamethasone on MRI of EH using a 3T MR machine and a novel heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed using a magnitude plus zero-filled interpolation (hT2FLAIR-MZFI) sequence.

Results

The retention times and peak area of dexamethasone in HPLC were not modified by the addition of Gd-DTPA. EH grading in the cochlea and vestibule was not influenced in any ear by intratympanic injection of dexamethasone. Excellent inner ear images were obtained from all patients, and EHs with various grades were displayed. There were significant correlations between diagnosis and cochlear EH (p < 0.01, Spearman's Rho), between diagnosis and vestibular EH (p < 0.01, Spearman's Rho), and between cochlear and vestibular EH (p < 0.01, Spearman's Rho). The distribution of Gd-DTPA plus dexamethasone negatively correlated with the grade of vestibular EH. Injury of the endolymph-perilymph barrier was detected in one cochlea and three vestibules of 59 inner ears with MD.

Conclusions

Intratympanic administration of Gd-DTPA plus dexamethasone yielded high-quality MRI images of EH in patients with MD using a novel 7-min protocol and simplified the clinical application. Intratympanic administration of Gd-DTPA plus dexamethasone might be used to test its therapeutic effect in future work.

Level of evidence

3.

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来源期刊
Journal of Otology
Journal of Otology Medicine-Otorhinolaryngology
CiteScore
2.70
自引率
0.00%
发文量
461
审稿时长
18 days
期刊介绍: Journal of Otology is an open access, peer-reviewed journal that publishes research findings from disciplines related to both clinical and basic science aspects of auditory and vestibular system and diseases of the ear. This journal welcomes submissions describing original experimental research that may improve our understanding of the mechanisms underlying problems of basic or clinical significance and treatment of patients with disorders of the auditory and vestibular systems. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines. Journal of Otology welcomes contributions from scholars in all countries and regions across the world.
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