壶腹T2低信号作为前庭萎缩标志的体内检测
In Vivo Detection of Ampullary T2 Hypointensity as a Marker of Vestibular Atelectasis.
文献信息
| PMID | 42970753 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Anna Dordonnat |
| 作者单位 | Department of Radiology, Clinique de l'Oreille. |
| 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
背景与目的： 前庭萎缩（VA）是一种组织学定义的膜迷路塌陷，常伴有致密嗜碱性沉积物。虽然延迟增强后3D-FLAIR成像可间接显示VA，但尚无嗜碱性沉积物的体内对应征象报道。本研究描述壶腹和椭圆囊内一种新的T2加权低信号，作为VA的潜在影像生物标志物，并探讨其在双侧前庭反射消失患者中的临床相关性。
材料与方法： 本回顾性研究纳入47例经视频头脉冲试验和前庭诱发肌源性电位确诊的双侧前庭反射消失患者。所有患者均接受3T MRI，包括延迟增强后3D-FLAIR和高分辨率T2加权序列。评估壶腹或椭圆囊T2低信号的存在与分布，并与影像学VA、临床表现及前庭功能进行相关性分析。
结果： 在纳入的47例患者中，32例（68.1%）发现VA。25例（53.2%）观察到明显的T2低信号，且仅见于VA组。与外侧壶腹相比，这些低信号在上壶腹和后壶腹中显著更常见（FDR-P<0.001）。VA患者显著更年轻、听力阈值更好且后管功能障碍更严重；短暂眩晕发作在该组更频繁，但未达到统计学显著性。在年龄校正的Firth logistic回归中，壶腹低信号是唯一与VA独立相关的变量（比值比：124.59，95% CI：5.35-2900.22；表观曲线下面积：0.973，95% CI：0.890-0.994），尽管由于准完全分离导致该估计不精确（FDR-P=0.0104）。
结论： 在本队列中，壶腹和椭圆囊内的T2低信号仅见于影像学前庭萎缩患者。其解剖分布与组织病理学系列中描述的嗜碱性沉积物相符，但在缺乏组织分析的情况下，这种对应关系仍属假设。当延迟增强后3D-FLAIR成像不可用或存在禁忌时，该MRI征象可提示VA的可能，但不能替代该检查。
英文摘要
BACKGROUND AND PURPOSE: Vestibular atelectasis (VA) is a histologically defined collapse of the membranous labyrinth, often accompanied by dense basophilic deposits. While delayed postcontrast 3D-FLAIR imaging allows indirect visualization of VA, no in vivo correlate of the basophilic deposits has been reported. This study describes a novel T2-weighted hypointense signal within the ampullae and utricle as a potential imaging biomarker of VA and explores its clinical relevance in patients with bilateral vestibular areflexia.
MATERIALS AND METHODS: This retrospective study included 47 patients with bilateral vestibular areflexia, confirmed by video Head Impulse Test and vestibular-evoked myogenic potentials. All underwent 3T MRI with delayed postcontrast 3D-FLAIR and high-resolution T2-weighted sequences. The presence and distribution of ampullary or utricular T2 hypointensities were evaluated and correlated with radiological VA, clinical presentation, and vestibular function.
RESULTS: Among the 47 patients included, VA was identified in 32 (68.1%). A distinct T2 hypointense signal was observed in 25 patients (53.2%), exclusively within the VA group. These hypointensities were significantly more prevalent in the superior and posterior ampullae compared to the lateral (FDR-P<0.001). VA patients were significantly younger, had better hearing thresholds and more severe posterior canal dysfunction; short vertigo episodes were more frequent in this group without reaching statistical significance. In age-adjusted Firth logistic regression, ampullary hypointensity was the only variable independently associated with VA (odds ratio: 124.59, 95% CI: 5.35-2900.22; apparent area under the curve: 0.973, 95% CI: 0.890-0.994), although the estimate was imprecise owing to quasi-complete separation (FDR-P=0.0104).
CONCLUSION: A T2 hypointense signal within the ampullae and utricle was observed exclusively in patients with radiological vestibular atelectasis in this cohort. Its anatomical distribution is compatible with the basophilic deposits described in histopathological series, although this correspondence remains hypothetical in the absence of tissue analysis. This MRI sign may raise suspicion of VA when delayed postcontrast 3D-FLAIR imaging is unavailable or contraindicated, rather than replace it.