MRI Inner Ear Imaging and Tone Burst Electrocochleography in the Diagnosis of Meniere's Disease

作者：Hornibrook Jeremy^*; Flook Edward; Greig Sam; Babbage Melissa; Goh Tony; Coates Mark; Care Rachel; Bird Philip

来源：Otology & Neurotology, 2015, 36(6): 1109-1114.

DOI：10.1097/MAO.0000000000000782

• Meniere's disease
• MRI inner ear imaging
• Tone burst electrocochleography

Objective To compare the sensitivity of gadolinium MRI inner imaging with tone burst electrocochleography (EcochG) for diagnosing endolymphatic hydrops.
Study Design A prospective study on patients who were to have an MRI scan to exclude retrocochlear pathology.
Setting Tertiary care center.
Patients One hundred and two patients: 57 patients with Possible, Probable, or Definite Meniere's Disease, 25 with asymmetrical hearing loss, 18 with sudden sensorineural hearing loss, and 2 with unilateral tinnitus had additional MRI inner ear imaging and click and tone burst stimulus EcochG testing.
Intervention Diagnostic.
Main Outcome Measure To compare the sensitivity of the two techniques.
Results In 30 patients with symptom-based Definite Meniere's Disease, tone burst EcochG was positive in 25 (83%) and the click EcochG was positive in 9/30 (30%), and gadolinium MRI imaging diagnosed hydrops in 14 (47%). A positive result for either MRI imaging or tone burst EcochG was seen in 26 patients (87%). In 14 subjects with symptom-based Probable Meniere's Disease, 10 (71%) had either a positive EcochG or MRI. In 13 with Possible Meniere's Disease, four (31%) had a positive EcochG or MRI.
Conclusion This study confirms the greatly enhanced diagnostic sensitivity of tone burst EcochG over click response in diagnosing endolymphatic hydrops in Meniere's disease. Even though adequate MRI imaging was achieved in 90%, tone burst EcochG was a more sensitive test.

• 出版日期2015-7