耳蜗电图与钆增强内耳MRI对梅尼埃病患者的诊断价值
Diagnostic Value of Electrocochleography and Gadolinium-Enhanced Inner Ear MRI for Patients With Meniere Disease.
文献信息
| PMID | 42748461 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Wenbin Wang |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China. |
| 期刊 | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology |
| SCI 分区 | Q2 |
| IF | 1.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 比较耳蜗电图（EcochG）与钆增强内耳MRI在确诊和可能梅尼埃病（MD）患者中的诊断效能，并评估其临床适用性。
研究设计： 回顾性队列研究。
地点： 三级转诊中心。
患者： 共纳入694例MD患者（765耳）。患耳分为确诊组（704耳）、可能组（61耳）和非MD组（无症状对侧耳，574耳）。此外，100只正常耳作为对照组。
干预： 鼓膜外EcochG记录和钆增强内耳MRI。
主要结局指标： 通过受试者工作特征分析评估EcochG参数（振幅比、area1比、area2比）和钆增强MRI的诊断准确性。
结果： MRI在区分确诊组与非MD组方面表现出最高的诊断准确性（敏感性79%，特异性99%）。相比之下，EcochG参数，尤其是area2比，在区分可能组与非MD组方面表现更优，其曲线下面积值显著高于MRI（P<0.05）。在MRI和EcochG参数中均观察到各组间的逐步梯度变化。然而，确诊组与可能组之间的面积比无显著差异。MRI表现与EcochG参数之间相关性较弱。
结论： MRI在确诊MD中具有较高的诊断价值，并能反映结构性病变负担，但其在早期或可能MD中的敏感性仍然有限。基于面积比的EcochG，尤其是area2比，似乎对与内淋巴积水相关的早期功能改变更为敏感。EcochG可作为早期检测的有价值补充工具，而MRI对于评估结构性受累仍必不可少。
英文摘要
OBJECTIVE: To compare the diagnostic performance of electrocochleography (EcochG) and gadolinium-enhanced inner ear MRI in patients with definite and probable Menière disease (MD) and to evaluate their clinical applicability.
STUDY DESIGN: Retrospective cohort study.
SETTING: Tertiary referral center.
PATIENTS: A total of 694 patients with MD (765 ears) were included. Ears were categorized into the definite group (704 ears), the probable group (61 ears), and the non-MD group (asymptomatic contralateral ears, 574 ears). In addition, 100 normal ears served as the control group.
INTERVENTIONS: Extratympanic EcochG recordings and gadolinium-enhanced inner ear MRI.
MAIN OUTCOME MEASURES: Diagnostic accuracy of EcochG parameters (amplitude ratio, area1 ratio, area2 ratio) and gadolinium-enhanced MRI, evaluated using receiver operating characteristic analysis.
RESULTS: MRI demonstrated the highest diagnostic accuracy in distinguishing the definite group from the non-MD group (sensitivity 79%, specificity 99%). In contrast, EcochG parameters, particularly the area2 ratio, showed superior performance in differentiating the probable group from the non-MD group, with significantly higher area under the curve values than MRI (P<0.05). A stepwise gradient was observed across groups for both MRI and EcochG parameters. However, area ratios did not significantly differ between the definite group and the probable group. There were weak correlations between MRI findings and EcochG parameters.
CONCLUSIONS: MRI exhibits high diagnostic value and reflects structural disease burden in definite MD, but its sensitivity in early-stage or probable MD remains limited. Area ratio-based EcochG, especially the area2 ratio, appears more sensitive to early functional alterations associated with endolymphatic hydrops. EcochG might serve as a valuable complementary tool for early detection, whereas MRI remains essential for assessing structural involvement.