A perspective from magnetic resonance imaging findings of the inner ear: Relationships among cerebrospinal, ocular and inner ear fluids

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• 作者：Tsutomu Nakashima^a ; ^{tsutomun@med.nagoya-u.ac.jp} ; Michihiko Sone^a ; Masaaki Teranishi^a ; Tadao Yoshida^a ; Hiroko Terasaki^b ; Mineo Kondo^b ; Tetsuhiro Yasuma^b ; Toshihiko Wakabayashi^c ; Tetsuya Nagatani^c ; Shinji Naganawa^d
• 关键词：Magnetic resonance imaging ; Hydrocephalus ; Mé ; niè ; re's disease ; Glaucoma ; Superior canal dehiscent syndrome ; Large vestibular aqueduct syndrome ; Aquaporin
• 刊名：Auris Nasus Larynx
• 出版年：2012
• 期刊代码：29_03858146
• 类别：med
• 出版时间：August, 2012
• 卷：39
• 期：4
• 页码：345-355
• 文件大小：817 K

摘要

Visualization of endolymphatic hydrops has been performed using magnetic resonance imaging (MRI) after intratympanic or intravenous gadolinium (Gd) injection. Our recent findings indicate that just as the prevalence of asymptomatic glaucoma is greater than that of symptomatic glaucoma, there are also many cases of asymptomatic endolymphatic hydrops. It is assumed that the asymptomatic endolymphatic hydrops that precedes M茅ni猫re's disease is found more frequently using MRI than with other techniques. Gd in the inner ear moves into the cerebrospinal fluid (CSF) via the internal auditory meatus. Gd enhancement is also recognized in the ocular fluid after the intravenous Gd administration. In this paper, the relationships between CSF, ocular fluid and inner ear fluid are reviewed. The central nervous system, eye and inner ear contain specialized extracellular fluids that are essential for maintaining their function: CSF, ocular fluid consisting of vitreous humor and aqueous humor, and inner ear fluid consisting of perilymph and endolymph. Abnormal accumulation of or pressure elevation in these fluids is associated with hydrocephalus, glaucoma and M茅ni猫re's disease, respectively. The dura mater and the arachnoid membrane of the optic nerve canal and inner ear meatus are very close to the eye and the inner ear, respectively. It has been reported that low CSF pressure is associated with glaucoma and endolymphatic hydrops. In glaucoma and M茅ni猫re's disease, nerve damage to ganglion cells rather than damage of the sensory cells is directly associated with progression of the disease. Retinal ganglion cells in glaucoma and spiral ganglion cells in M茅ni猫re's disease are targets of the abnormal accumulation of, or increased pressure in, the extracellular fluid, just as neurons are damaged in hydrocephalus. Studies on hydrocephalus, glaucoma and M茅ni猫re's disease as a group may deepen our understanding of each disease.