Evaluation of the blood–perilymph barrier in ears with endolymphatic hydrops

Abstract

Background

Otological diseases including Meniere’s disease (MD) involve endolymphatic hydrops (EH), which can be visualized by magnetic resonance imaging (MRI) with gadolinium contrast agents, but the temporal changes of contrast in the inner ear have not been evaluated.

Objectives

We investigated the permeability of the blood–perilymph barrier (BPB) in ears with EH to evaluate the severity of the inner ear disturbances.

Materials and methods

The study included 32 ears from 16 patients with EH or related diseases who underwent MRI. The permeability of the BPB was assessed by the signal–intensity ratio (SIR) at four-time points: before and at 10 min, 4 h, and 24 h after administration of gadolinium for assessing EH.

Results

Cochlear EH was found in 25 of the 32 ears, and vestibular EH in 11. The rate of EH was significantly higher in symptomatic ears; however, the existence of EH was not related to SIR values. Nevertheless, SIR values in the basal turn were significantly higher 4 and 24 h after injection of gadolinium in patients aged ≥50 years.

Conclusion and significance

Higher SIR values observed in older patients with EH indicate severe disturbances of the BPB in the cochlea, which may account for intractable inner ear disturbances in older patients.

Chinese abstract

背景：包括美尼尔氏病 (MD) 在内的耳科疾病涉及内淋巴积水 (EH), 它可通过使用钆造影剂的磁共振成像 (MRI) 而显现, 但尚未评估内耳对比度的时间性变化。

目的：我们研究了 带EH 的耳部血-外淋巴屏障 (BPB) 的滲透性, 以评估内耳障碍的严重程度。

材料和方法：该研究包括来自 16 名 EH 或相关疾病患者的 32 个耳朵, 这些患者接受了核磁共振检查。 BPB 的渗透性通过信号强度比 (SIR) 在四个时间点进行评估：在使用钆评估 EH 之前和之后的 10 分钟、4 小时和 24 小时。

结果：耳蜗EH 发现于32个耳中的25个耳, 前庭EH发现于11个耳。症状耳的EH发生率明显较高；然而, EH 的存在与 SIR 值无关。尽管如此, 50 岁及以上患者在注射钆后 4 小时和 24 小时, 基底转角的 SIR 值显著升高。

结论和意义：在老年 EH 患者中观察到的较高 SIR 值表明耳蜗内 BPB 的严重损坏, 这可能是老年患者难治性内耳损坏的原因。

Keywords:

• MRI
• endolymphatic hydrops
• signal intensity

Disclosure statement

No potential conflict of interest was reported by the author(s).