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

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 of spatium 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%, specificity 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. (authors)