健康志愿者无症状内淋巴水肿的预后：一项为期五年的队列研究

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY Laryngoscope Investigative Otolaryngology Pub Date : 2024-11-07 DOI:10.1002/lio2.70026

Takahiro Kimura MD, PhD, Tadashi Kitahara MD, PhD, Tadao Okayasu MD, PhD, Masaharu Sakagami MD, PhD, Tomoyuki Shiozaki PhD, Hiroshi Inui MD, PhD, Toshizo Koizumi MD, PhD, Mariko Kakudo MD, PhD

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引用次数: 0

摘要

背景：本研究旨在通过内耳磁共振成像（MRI）对健康志愿者进行五年随访，以明确无症状内淋巴水肿（EH）的预后：方法：对在之前的梅尼埃病研究中作为对照组招募的 115 名参与者进行了内耳磁共振成像。采用静脉注射钆的长川对比增强磁共振成像法观察内淋巴间隙，并采用中岛二维成像分析法进行评估：7.0%的参与者（n = 8）存在耳蜗或前庭EH，所有病例均为单侧（侧位）、中度（严重程度）和无症状（发病）。仅存在耳蜗定位 EH、仅存在前庭定位 EH 和同时存在两种 EH 的参与者分别占 1.7%（n = 2）（C 组）、4.3%（n = 5）（V 组）和 0.9%（n = 1）（CV 组）。5 年后进行的内耳磁共振成像显示，C 组和 V 组的两名参与者（4/8，50.0%）的 EH 几乎消失。V 组的 3 名参与者和 CV 组的 1 名参与者（4/8，50.0%）的 EH 仍然存在。V 组的一名参与者和 CV 组的另一名参与者出现了残余的内耳 EH，并发展成典型的无症状美尼尔氏病（2/8，25.0%）：约 7% 的健康参与者表现为无症状 EH。因此，EH 并不是诊断美尼尔氏病的明确标志，也不是预测美尼尔氏病发展的合适指标。在这些参与者中，有 25% 的人保持了 EH，并在随后的 5 年内患上了典型的美尼尔氏病。谢隆阳性参与者的内耳持续存在EH，自我抑郁量表得分较高的参与者在5年后出现了美尼尔症状。

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Prognosis of asymptomatic endolymphatic hydrops in healthy volunteers: A five-year cohort study

Background

This study aimed to clarify the prognosis of asymptomatic endolymphatic hydrops (EH) in healthy volunteers via five-year follow-ups with inner ear magnetic resonance imaging (MRI).

Methods

Inner ear MRI was performed on 115 participants recruited as controls in a previous study on Meniere's disease. The endolymphatic space was visualized using Naganawa's method of contrast-enhanced MRI with intravenous gadolinium injection and evaluated using Nakashima's method of 2D imaging analysis.

Results

Cochlear or vestibular EH was present in 7.0% of participants (n = 8), with all cases being unilateral (laterality), moderate (severity), and asymptomatic (onset). Only cochlear-localized EH, only vestibular-localized EH, and both EH were present in 1.7% (n = 2) (C group), 4.3% (n = 5) (V group), and 0.9% (n = 1) (CV group) of participants, respectively. Conducting inner ear MRI after 5 years showed that EH had almost disappeared in two participants in the C and V groups (4/8, 50.0%). EH was still present in three participants in the V group and one in the CV group (4/8, 50.0%). One participant in the V group and another in the CV group presented with residual inner ear EH and developed typical symptomatic Meniere's disease (2/8, 25.0%).

Conclusions

Approximately 7% of healthy participants showed asymptomatic EH. Therefore, EH is not the definitive marker for making a diagnosis of Meniere's disease or the suitable predictor for the development of Meniere's disease. Among these participants, 25% maintained EH and subsequently developed typical Meniere's disease within the next 5 years. Schellong-positive participants maintained persistent EH in the inner ear, and participants with higher scores on the self-rating depression scale developed Meniere's symptoms after 5 years.