目的:比较不同前庭内淋巴积水(EH)分级方法与梅尼埃病(MD)听力损失严重程度的相关性,并评价这些方法对MD的诊断价值。
方法:这项回顾性研究包括2021年6月至2023年8月诊断为MD的30例患者。所有患者均使用三维(3D)真实反转恢复序列和纯音测听法进行了内耳MRg增强成像。根据Nakashima等人概述的分类方法独立评估EH水平。(《耳鼻喉科学报》,2009年,第5-8号。https://doi.org/10.1080/00016480902729827)(M1),方等人。(JLaryngolOtol126:454-459,2012。https://doi.org/10.1017/S0022215112000060)(M2),Barathetal.(AmJNeuroradiol35:1387-1392,2014。https://doi.org/10.3174/ajnr.A3856),(M3),Liuetal.(前传9:874971,2022年。https://doi.org/10.3389/fsurg.202.874971),(M4),和Bernaerts等人。(神经放射学61:421-429,2019年。https://doi.org/10.1007/s00234-019-02155-7)(M5),随后对观察员之间的协议进行了比较。达成共识后,使用不同的方法对前庭EH分级之间的相关性进行了分析,中低端的平均听力阈值,high,以及完整的频率和临床阶段。然后比较这些方法对MD的诊断能力。
结果:M2-M5的观察者间一致性优于M1。基于M4的EH分级显示与中低的平均听力阈值显着相关,high,以及完整的频率和临床阶段。M1、M2、M3和M5与一些参数相关。接收器工作特性曲线分析表明,就MD的诊断效率而言,M5明显优于M1,M2,M3和M4。
结论:M4与MD患者的听力损失程度相关性最强,而M5显示出最高的诊断性能。
OBJECTIVE: To compare the correlation between different grading methods of vestibular endolymphatic hydrops (EH) and the severity of hearing loss in Ménière\'s disease (MD), and evaluate the diagnostic value of these methods in diagnosing MD.
METHODS: This retrospective study included 30 patients diagnosed with MD from June 2021 to August 2023. All patients underwent inner ear MR gadolinium-enhanced imaging using three-dimensional (3D)-real inversion recovery sequences and pure-tone audiometry. The EH levels were independently evaluated according to the classification methods outlined by Nakashima et al. (Acta Otolaryngol Suppl 5-8, 2009. https://doi.org/10.1080/00016480902729827 ) (M1), Fang et al. (J Laryngol Otol 126:454-459, 2012. https://doi.org/10.1017/S0022215112000060 ) (M2), Barath et al. (Am J Neuroradiol 35:1387-1392, 2014. https://doi.org/10.3174/ajnr.A3856 ), (M3), Liu et al. (Front Surg 9:874971, 2022. https://doi.org/10.3389/fsurg.2022.874971 ), (M4), and Bernaerts et al. (Neuroradiology 61:421-429, 2019. https://doi.org/10.1007/s00234-019-02155-7 ) (M5), with a subsequent comparison of interobserver agreement. After achieving a consensus, an analysis was performed to explore the correlations between vestibular EH grading using different methods, the average hearing thresholds at low-mid, high-, and full frequencies and clinical stages. The diagnostic capabilities of these methods for MD were then compared.
RESULTS: The interobserver consistency of M2-M5 was superior to that of M1. The EH grading based on M4 showed a significant correlation with the average hearing thresholds at low-mid, high-, and full frequencies and clinical stages. M1, M2, M3, and M5 correlated with some parameters. A receiver operating characteristic curve analysis indicated that M5 significantly outperformed M1, M2, M3, and M4 in terms of diagnostic efficiency for MD.
CONCLUSIONS: M4 showed the strongest correlation with the degree of hearing loss in patients with MD, whereas M5 showed the highest diagnostic performance.