摘要
目的:采用三维真实重建反转恢复(3D-real IR)序列,对比基于耳蜗和前庭的不同评估方法对梅尼埃病(MD)内淋巴积水的检出效能。方法:回顾性收集2018年8月-2022年2月于首都医科大学附属北京友谊医院就诊,符合2017年中华医学会耳鼻咽喉头颈外科学分会诊断标准,且经鼓膜注入钆对比剂24小时后行3D-real IR序列检查的MD患者38例(45耳);同时纳入因单侧耳部症状就诊且行内耳MR钆造影检查、临床纯音测听、声阻抗、声放射检查未见明确异常的患者或MD患者的非症状侧作为对照组,共28例(30耳)。采用国内外最常用的4种基于耳蜗和前庭的评估方法(分别于2009年、2011年、2014年、2019年提出)分别判定有无内淋巴积水,分析每种方法诊断MD内淋巴积水的不同观察者间一致性、敏感度和特异度,采用MedCalc软件绘制受试者操作特征(ROC)曲线,对比不同方法诊断MD内淋巴积水的ROC曲线下面积(AUC)差异。结果:2009年、2011年、2014年、2019年评估方法的不同观察者间Cohen′s K系数分别为0.752、0.911、0.820、0.820,敏感度/特异度分别为91.1%/50%、93.3%/70%、82.2%/56.7%、82.2%/56.7%。2011年方法检出MD内淋巴积水的AUC显著高于其他三种方法(Z_(2009)=2.866,P_(2009)=0.0042;Z_(2014)=2.647,P_(2014)=0.0081;Z2019=2.647,P_(2019)=0.0081)。结论:2011年评估方法在3D-real IR序列上的观察者间一致性好、诊断效能高,推荐临床应用。
Objective:To compare the diagnostic efficacy of different methods in the diagnosis of endolymphatic hydrops in Meniere′s disease(MD)based on three-dimensional real inversion recovery(3D real IR)sequence.Methods:Thirty-eight MD patients(45 ears)who were admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from August 2018 to February 2022 and met the diagnostic criteria for MD issued by the Otolaryngology Head and Neck Surgery Branch of Chinese Medical Association in 2017 were retrospectively collected.After injecting gadolinium contrast agent into the tympanic membrane for 24 hours,3D-real IR sequence examination was performed.28 patients(30 ears)with unilateral ear symptoms who underwent inner ear MR gadolinium contrast examination,clinical pure tone audiometry,acoustic impedance,and acoustic radiation examination without clear abnormalities,or the asymptomatic side of MD patients were selected as the control group.The four most commonly used evaluation methods based on cochlea and vestibular(proposed in 2009,2011,2014 and 2019,respectively)were used to determine the presence or absence of endolymphatic hydrops,and the consistency among different observers,sensitivity and specificity of each method in determining MD endolymphatic hydrops were analyzed.MedCalc software was used to compare the difference of the area under the curve(AUC)of different methods.Results:The Cohen′sκcoefficient among different observers was 0.752 for 2009,0.911 for 2011,0.820 for 2014 and 0.820 for 2019,respectively.The sensitivity/specificity were 91.1%/50%、93.3%/70%、82.2%/56.7%、82.2%/56.7%,respectively.Using the method proposed in 2011 to detect endolymphatic hydrops in MD,the AUC was significantly higher than that by the other three methods(Z_(2009)=2.866,P_(2009)=0.0042;Z_(2014)=2.647,P_(2014)=0.0081;Z_(2019)=2.647,P_(2019)=0.0081).Conclusion:The method proposed in 2011 has good inter-observer consistency and high diagnostic efficacy on 3D-real IR sequence and is recommended for clinical application.
出处
《放射学实践》
CSCD
北大核心
2024年第11期1448-1452,共5页
Radiologic Practice
基金
国家自然科学基金项目(61931013,82171886,62171297,82202098)
北京自然科学基金项目(7222301)。
关键词
梅尼埃病
内淋巴积水
迷路
耳蜗
前庭
磁共振成像
Meniere′s disease
Endolymphatic hydrops
Labyrinth
Cochlea
Vestibule
Magnetic resonance imaging
