MR score system on spatium perilymphaticum gadolinium opacification and its application for diagnosis of Meniere's disease

Abstract

Objective To propose a MR scoring methods for spatium perilymphaticum gadolinium opacification and explore the value of their diagnosis of Meniere' s disease. Methods Fifty-one asymptomatic and 65 symptomatic patients with Meniere's disease were enrolled in this study.MR imaging ofspatium perilymphaticum after intratypanic gadolinium injection were analyzed with following scoring method. ( 1 ) Semicircular canal not visualized equal to score 0 ; some visualized equal score 1 ; full visualized equal score 2.(2)There were high-signal and low-signal in the vestibule,low-signal areas above the lateral semicircular canal plane equal score 6 ; low signal areas down to lateral semicircular canal plane equal score 3 ; no higher signal in the vestibule area equal score 0.( 3 ) Basal turn of cochlea:full visualized equal score 3; part visualized equal score 2; scala vestibule of basal turn smaller than scala tympani equal score 1 regardless of full or visualized in basal turn; no visualized equal score 0. Medial turn of cochlea:full visualized equal score 2 ; part visualized equal score 1 ; no visualized equal score 0.Apical turn of cochlea: visualized equal score 1 ; no visualized equal score 0. One radiologist scored all cases with double blind. SPSS 17.0 software was used to conduct multiple independent-samples nonparametric tests,multivariate Logistic regression, and ROC curve analysis. Evaluate the sensitivity and specificity for diagnosis of Meniere's disease with the scoring system. Results ( 1 ) Meniere's disease summation score 0 to 12,median 9 (quarter spacing 4.5 ) ; no symptoms group summation score 15 to 18,median 17 (quarter spacing 3),two group differences has statistics significance (Wilcoxon rank and inspection U =-9.118,P =0.00).(2)Based on summation score for the diagnosis of Meniere's disease,tangent point was 14.5,Youden index 0.969,specificity 100.0％,sensitivity 96.9％.( 3 ) Let cochlear,vestibular,semicircular canal scoring for association variable,Logistic regression model:LogitP =61.216 - 7.381 × vestibular -3.056 × canal,based on the P value of ROC curves,diagnostic cut-off point 0.651 (vestibular ≤ 3 or semicircular canals ≤ 4 points ),Youden index 96.9％,specifisity 100.0％, sensitivity 96.9％.Conclusions Perilymphatic space of gadolinium contrast MR score in distinguishing Meniere's disease have practical value,any case meet one of following point could be diagnostic:( 1 ) Perilymphatic space of gadolinium contrast MRI total less than 14.5 ; (2) Vestibular low signal areas down more than lateral semicircular canal plane,namely vestibular score value ≤3;( 3 )Semicircular Canal scoring value ≤4. Key words: Magnetic resonance imaging; Ear, inner; Perilymph ; Gadolinium DTPA