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1.
Eur Radiol ; 33(12): 8693-8702, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37382619

RESUMEN

OBJECTIVES: To evaluate the effect of intraoperative pain in microwave ablation of lung tumors (MWALT) on local efficacy and establish the pain risk prediction model. METHODS: It was a retrospectively study. Consecutive patients with MWALT from September 2017 to December 2020 were divided into mild and severe pain groups. Local efficacy was evaluated by comparing technical success, technical effectiveness, and local progression-free survival (LPFS) in two groups. All cases were randomly allocated into training and validation cohorts at a ratio of 7:3. A nomogram model was established using predictors identified by logistics regression in training dataset. The calibration curves, C-statistic, and decision curve analysis (DCA) were used to evaluate the accuracy, ability, and clinical value of the nomogram. RESULTS: A total of 263 patients (mild pain group: n = 126; severe pain group: n = 137) were included in the study. Technical success rate and technical effectiveness rate were 100% and 99.2% in the mild pain group and 98.5% and 97.8% in the severe pain group. LPFS rates at 12 and 24 months were 97.6% and 87.6% in the mild pain group and 91.9% and 79.3% in the severe pain group (p = 0.034; HR: 1.90). The nomogram was established based on three predictors: depth of nodule, puncture depth, and multi-antenna. The prediction ability and accuracy were verified by C-statistic and calibration curve. DCA curve suggested the proposed prediction model was clinically useful. CONCLUSIONS: Severe intraoperative pain in MWALT reduced the local efficacy. An established prediction model could accurately predict severe pain and assist physicians in choosing a suitable anesthesia type. CLINICAL RELEVANCE STATEMENT: This study firstly provides a prediction model for the risk of severe intraoperative pain in MWALT. Physicians can choose a suitable anesthesia type based on pain risk, in order to improve patients' tolerance as well as local efficacy of MWALT. KEY POINTS: • The severe intraoperative pain in MWALT reduced the local efficacy. • Predictors of severe intraoperative pain in MWALT were the depth of nodule, puncture depth, and multi-antenna. • The prediction model established in this study can accurately predict the risk of severe pain in MWALT and assist physicians in choosing a suitable anesthesia type.


Asunto(s)
Neoplasias Pulmonares , Microondas , Humanos , Microondas/uso terapéutico , Estudios Retrospectivos , Dolor , Neoplasias Pulmonares/cirugía , Nomogramas , Tomografía Computarizada por Rayos X
2.
Arterioscler Thromb Vasc Biol ; 40(12): 2965-2974, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33028099

RESUMEN

OBJECTIVE: To determine the bilaterally asymmetrical associations between extracranial carotid artery atherosclerosis and ipsilateral middle cerebral artery (MCA) stenosis in symptomatic patients using magnetic resonance vessel wall imaging. Approach and Results: Patients with symptomatic carotid artery atherosclerosis were recruited from the Chinese Atherosclerosis Risk Evaluation, a multicenter study. All subjects underwent intracranial magnetic resonance angiography and extracranial carotid artery magnetic resonance imaging. Severe stenosis (stenosis ≥50%) of MCA, carotid moderate-to-severe stenosis (stenosis ≥50%), plaque compositions, and high-risk plaque on symptomatic side were evaluated in all subjects. Associations between ipsilateral MCA stenosis and extracranial carotid plaque features were evaluated. A total of 363 patients (mean age: 61.2±10.4 years old; 254 males) were included. In the left symptomatic cerebrovascular group (n=186), carotid moderate-to-severe stenosis (odds ratio [OR], 3.00 [95% CI, 1.03-8.79]; P=0.045), intraplaque hemorrhage (OR, 3.68 [95% CI, 1.21-11.19]; P=0.021), fibrous cap rupture (OR, 5.70 [95% CI, 1.60-20.31]; P=0.007), and high-risk plaque (OR, 2.95 [95% CI, 1.19-7.35]; P=0.020) were significantly associated with ipsilateral severe MCA stenosis, after adjusting for confounding factors. In the right symptomatic cerebrovascular group (n=177), severe MCA stenosis was significantly associated with ipsilateral carotid moderate-to-severe stenosis (OR, 3.98 [95% CI, 1.54-10.32]; P=0.004) but not with other extracranial carotid plaque features (all P>0.05), after adjusting for confounding factors. CONCLUSIONS: In the symptomatic arteries, vulnerable plaque features are independently associated with ipsilateral severe MCA stenosis on the left side, but this association is not found on the right side, indicating the associations of atherosclerotic disease between intracranial and extracranial carotid arteries are asymmetrical.


Asunto(s)
Estenosis Carotídea/diagnóstico por imagen , Angiografía Cerebral , Arteriosclerosis Intracraneal/diagnóstico por imagen , Angiografía por Resonancia Magnética , Arteria Cerebral Media/diagnóstico por imagen , Placa Aterosclerótica , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estenosis Carotídea/complicaciones , China , Estudios Transversales , Femenino , Humanos , Arteriosclerosis Intracraneal/complicaciones , Ataque Isquémico Transitorio/etiología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores de Riesgo , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/etiología , Adulto Joven
3.
J Stroke Cerebrovasc Dis ; 29(2): 104448, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31852597

RESUMEN

OBJECTIVES: To investigate the differences in characteristics of carotid plaques between patients Xining at high altitude and Jinan at sea level using magnetic resonance (MR) imaging. METHODS: Subjects were recruited from a cross-sectional, observational, multicenter imaging study of CARE-II study. Forty-nine (mean age 63.3 ± 12.0 years, 33 males) and 51 (mean age 64.5 ± 12.0 years, 34 males) patients were recruited from a site located in a high altitude region and a site located near sea level, respectively. All patients underwent multicontrast MR vessel wall imaging for carotid arteries on 3.0 T MR scanner. The carotid plaques features were compared between 2 patient groups. RESULTS: Compared with patients at sea level, those at high altitude had significantly greater lumen area (58.5 ± 17.8 mm2 versus 50.0 ± 19.6 mm2, P = .008), smaller maximum normalized wall index (48.6% ± 14.2% versus 57.8% ± 16.3%, P = .002), and smaller percentage volume of calcium (0.9% versus 5.6%, P < .001) in the symptomatic carotid artery. After adjustment for clinical risk factors including age, sex, systolic blood pressure, LDL-C, and statin use, these differences in plaque morphology and composition remained statistically significant. After further adjustment for normalized wall index as a measure of plaque burden, percentage volume of calcification was still significantly smaller in patients at high altitude area than that in patients at sea level area (P = .047). CONCLUSION: Symptomatic subjects from a high altitude area have lower plaque burden and less calcification in the carotid artery compared to those from an area near sea level.


Asunto(s)
Altitud , Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Angiografía por Resonancia Magnética , Placa Aterosclerótica , Calcificación Vascular/diagnóstico por imagen , Anciano , Enfermedades de las Arterias Carótidas/epidemiología , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Calcificación Vascular/epidemiología
4.
Eur Radiol ; 28(2): 708-717, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28770405

RESUMEN

OBJECTIVES: To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). METHODS: Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. RESULTS: Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance. CONCLUSION: Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. KEY POINTS: • Placental bulge type-II demonstrated the strongest independent association with PP. • Uterine serosal hypervascularity is a useful feature for differentiating PP from PA. • MRI features associated with abnormal vessels increase the risk of massive haemorrhage.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Placenta Accreta/diagnóstico , Placenta Previa/diagnóstico , Placenta/patología , Diagnóstico Prenatal , Útero/irrigación sanguínea , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Embarazo , Estudios Retrospectivos , Útero/diagnóstico por imagen , Adulto Joven
5.
Eur Radiol ; 26(10): 3737-43, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26670319

RESUMEN

OBJECTIVES: To assess the difference between carotid haemorrhagic plaque and non-haemorrhagic plaque by using diffusion-weighted imaging (DWI) and to evaluate carotid intraplaque haemorrhage (IPH) and intramural hematoma (IMH) of cervical artery dissection with apparent diffusion coefficient (ADC) measurement. METHODS: Fifty-one symptomatic patients underwent 3.0-T carotid MR imaging, including conventional sequences, three-dimensional (3D) magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequence, and DWI. Thirty-nine patients with carotid plaque and eight patients with IMH of cervical artery dissection were finally included. The groups of hemorrhagic plaque, non-hemorrhagic plaque and IMH were divided according to 3D MPRAGE sequence. ADC values of different groups were measured, and t tests were performed. RESULTS: The mean ADC values of hemorrhagic plaques, non-hemorrhagic plaque and IMH were (1.284 ± 0.327) × 10(-3)mm(2)/s, (1.766 ± 0.477) × 10(-3)mm(2)/s, and (0.563 ± 0.119) × 10(-3)mm(2)/s, respectively. The mean ADC values of hemorrhagic and non-hemorrhagic regions in the hemorrhagic plaque group were (0.985 ± 0.376) × 10(-3)mm(2)/s and (1.480 ± 0.465) × 10(-3)mm(2)/s, respectively. The differences between the hemorrhagic plaque and non-hemorrhagic plaque, hemorrhagic region and non-hemorrhagic region in hemorrhagic plaque, and the hemorrhagic region in the hemorrhagic plaque and IMH of artery dissection were significant (P < 0.05). CONCLUSION: DWI may be a useful complement to conventional MR imaging for identifying haemorrhage of carotid plaques and differentiate IMHs from IPH. KEY POINTS: • ADC values of IPH are lower than the plaque without IPH. • DWI might be a useful complement to identify IPH. • IMH may be differentiated from IPH by using DWI.


Asunto(s)
Disección de la Arteria Carótida Interna/diagnóstico por imagen , Estenosis Carotídea/diagnóstico por imagen , Hemorragia/diagnóstico por imagen , Placa Aterosclerótica/diagnóstico por imagen , Adulto , Anciano , Arterias Carótidas/diagnóstico por imagen , Diagnóstico Diferencial , Difusión , Imagen de Difusión por Resonancia Magnética/métodos , Femenino , Hematoma/diagnóstico por imagen , Humanos , Angiografía por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad
7.
Pediatr Res ; 75(3): 436-42, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24477071

RESUMEN

BACKGROUND: Susceptibility-weighted imaging (SWI) is a useful tool for evaluating brain paramagnetic mineralization. The aim of this study was to evaluate SWI filtered phase shift in brain gray nuclei of Wilson's disease (WD). METHODS: Twenty-three WD patients and 23 age- and gender-matched healthy controls underwent SWI. Phase values of bilateral brain gray nuclei were measured on corrected phase image of all subjects. RESULTS: Compared with healthy controls, WD patients showed a trend of negative phase shift in all regions of interest, and significantly lower phase value was found in bilateral putamen (PU) (left P = 0.009, right P = 0.001), caudate (left P = 0.001, right P = 0.001), thalamus (TH) (left P < 0.001, right P < 0.001), red nucleus (left P = 0.031, right P = 0.049), and substantia nigra (left P = 0.003, right P = 0.047). The WD patients groups were divided into neurological, hepatic, and asymptomatic onset subgroups. And neurological onset patients had lower phase value than hepatic onset patients on bilateral PU (left P = 0.025, right P = 0.002) and TH (left P = 0.025, right P = 0.025). CONCLUSION: Abnormal negative phase value was significantly increased in brain gray nuclei of WD patients, giving evidence in vivo about paramagnetic mineralization accumulating in brain gray nuclei. The phase shift of SWI could be used as a potential biomarker to help in diagnosing and evaluating WD.


Asunto(s)
Biomarcadores , Degeneración Hepatolenticular/diagnóstico , Degeneración Hepatolenticular/patología , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino
8.
Stroke Vasc Neurol ; 8(4): 284-291, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-36596656

RESUMEN

BACKGROUND AND PURPOSE: Atherosclerosis is a very complex process influenced by various systemic and local factors. Therefore, in patients with bilateral carotid plaques (BCPs), there may be differences in carotid plaque vulnerability between the sides. We aimed to investigate the differences in BCP characteristics in patients with BCPs using magnetic resonance vessel wall imaging (MR-VWI). METHODS: Participants with BCPs were selected for subanalysis from a multicentre study of Chinese Atherosclerosis Risk Evaluation II. We measured carotid plaque burden, identified each plaque component and measured their volume or area bilaterally on MR-VWI. Paired comparisons of the burden and components of BCPs were performed. RESULTS: In all, 540 patients with BCPs were eligible for analysis. Compared with the right carotid artery (CA), larger mean lumen area (p<0.001), larger mean wall area (p=0.025), larger mean total vessel area (p<0.001) and smaller normalised wall index (p=0.006) were found in the left CA. Regarding plaque components, only the prevalence of lipid-rich necrotic core (LRNC) in the left CA was higher (p=0.026). For patients with a vulnerable plaque component coexisting on both sides, only the intraplaque haemorrhage (IPH) volume (p=0.011) was significantly greater in the left CA than in the right CA. CONCLUSIONS: There were asymmetries in plaque growth and evolution between BCPs. The left carotid plaques were more likely to have larger plaque burden, higher prevalence of LRNC and greater IPH volume, which may contribute to the lateralisation of ischaemic stroke in the cerebral hemispheres.


Asunto(s)
Aterosclerosis , Isquemia Encefálica , Estenosis Carotídea , Placa Aterosclerótica , Accidente Cerebrovascular , Humanos , Estenosis Carotídea/complicaciones , Estenosis Carotídea/diagnóstico por imagen , Accidente Cerebrovascular/complicaciones , Arterias Carótidas/diagnóstico por imagen , Placa Aterosclerótica/complicaciones , Hemorragia , Aterosclerosis/complicaciones
9.
J Cancer Res Ther ; 17(3): 671-675, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34269298

RESUMEN

OBJECTIVES: The aim of this study was to evaluate the feasibility, accuracy, and safety of computed tomographic (CT)-guided coil localization before video-assisted thoracoscopic surgery. METHODS: One hundred and eighty-four consecutive patients with 200 pulmonary nodules who underwent CT-guided percutaneous coil localization before thoracoscopic surgery were retrospectively analyzed in this study. Success rate for localization, complication rates, CT findings, and pathological results of the lesions, as well as the data related to surgery were all recorded and analyzed. RESULTS: All 184 patients with 200 lesions completed localization and resection. The success rate of the coil localization on lesion baseline was 99.0% (198/200) and 98.9% (182/184) on patient baseline. The number of wedge resection, segmental resection, and lobectomy were 179 (89.5%), 19 (9.5%), and 2 (1.0%), respectively. The malignancy rates in a lesion-based analysis were 83.5% (91.1% in ground-glass nodules, 91.4% in part-solid nodules, and 37.9% in solid nodules). No serious complications occurred in all localization procedures. CONCLUSION: Preoperative CT-guided percutaneous coil localization is a safe and effective method to facilitate high success rates for both wedge and segmental resection for peripheral pulmonary nodules.


Asunto(s)
Marcadores Fiduciales , Neoplasias Pulmonares/cirugía , Nódulos Pulmonares Múltiples/cirugía , Neumonectomía/instrumentación , Nódulo Pulmonar Solitario/cirugía , Cirugía Torácica Asistida por Video/instrumentación , Adulto , Anciano , Estudios de Factibilidad , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Pulmón/cirugía , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Nódulos Pulmonares Múltiples/diagnóstico , Nódulos Pulmonares Múltiples/patología , Neumonectomía/métodos , Cuidados Preoperatorios/instrumentación , Estudios Retrospectivos , Nódulo Pulmonar Solitario/diagnóstico , Nódulo Pulmonar Solitario/patología , Tomografía Computarizada por Rayos X
10.
Acta Otolaryngol ; 136(10): 1051-7, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27187111

RESUMEN

CONCLUSION: Children with CND received limited benefits from CIs and their results varied. The size of the vestibulocochlear nerve relative to the facial nerve could potentially be used as a predicator for CI outcomes in children with CND. OBJECTIVE: This study aimed to (1) retrospectively review the outcomes of cochlear implants (CIs) in children with cochlear nerve deficiency (CND) and (2) evaluate the clinical usefulness of radiological findings as predictors for post-implantation outcomes. METHODS: Study participants included 10 children with bilateral CND and profound sensorineural hearing loss. The preoperative magnetic resonance imaging and temporal bone computed tomography scans were evaluated. Auditory processing capability and speech perception performance were measured with Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scales. Aided hearing thresholds with CI were measured. The relationships between CI outcomes and the sizes of vestibulocochlear nerve and cochlear nerve canal (CNC) were analysed. RESULTS: Although post-operative CAP scores and hearing thresholds significantly improved in children with CND, their results were worse than those measured in implanted children with normal cochlear nerve. No significant correlation was found between the CI outcomes and the vestibulocochlear nerve diameters or the CNC diameters in children with CND. However, children with larger vestibulocochlear-nerve-to-facial-nerve-ratios got better results.


Asunto(s)
Implantación Coclear , Enfermedades del Nervio Vestibulococlear/cirugía , Niño , Preescolar , Femenino , Humanos , Lactante , Imagen por Resonancia Magnética , Masculino , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Enfermedades del Nervio Vestibulococlear/diagnóstico por imagen
11.
Artículo en Zh | MEDLINE | ID: mdl-26696344

RESUMEN

OBJECTIVE: To investigate the effect and mechanism of endolymphatic sac-mastoid shunt surgery for intractable Meniere's disease of different stages according to hearing level. METHODS: Data from 240 patients diagnosed with unilateral MD strictly meeting the criteria issued by Chinese Academy of Otolaryngology-Head and Neck Surgery Committee (2006) from January 1983 to January 2012 were analyzed in this study. Endolymphatic sac-mastoid shunt surgery was performed in affected ear for each patient. The evaluation of therapy followed the guidelines issued by Chinese Academy of Otolaryngology Head and Neck Surgery Committe. Vertigo control and auditory function were measured in two-year's follow-up. RESULTS: According to the preoperative staging of hearing, among these 240 patients, there were 12 cases in stage I (with an average hearing threshold < 25 dB), 130 cases in stage II (with an average hearing threshold of 25-40 dB), 85 in stage III (41-70 dB) and 13 cases in stage IV(with an average hearing threshold > 70 dB). Overall control rate of vertigo was 77.9% (187/240) in two-year's follow-up, with total control 49.2% (118/240) and substantial control 28.7% (69/240). The hearing was improved in 25.0% (60/240) of cases, no change in 59.2% (142/240) of cases, and worse in 15.8% (38/240) of cases. According to different stages, vertigo control rate was 83.3% (10/12) in stage I, 82.3% (107/130) in stage II, 75.3% (64/85) in stage III and 46.2% (6/13) in stage IV. Vertigo control rate of stage IV patients was significantly lower than that of stage II and III patients (χ(2) = 9.318 and 4.692, P < 0.05), while vertigo control rate of stage I, II, III patients had no significant difference with each other (P > 0.05). CONCLUSION: Endolymphatic sac-mastoid shunt operation is an effective method in the treatment of intractable Meniere's disease, but the effect was poor in stage IV patients.


Asunto(s)
Saco Endolinfático/cirugía , Apófisis Mastoides/cirugía , Enfermedad de Meniere/cirugía , Procedimientos Quirúrgicos Otológicos , Audición , Humanos , Vértigo/terapia
12.
Artículo en Zh | MEDLINE | ID: mdl-24195817

RESUMEN

OBJECTIVE: To study the feasibility of endolymphatic visualization and the diagnosis of Meniere's disease by applying intratympanic gadolinium administration through the tympanic membrance and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI). To study the relationship between the endolymphatic hydrops visualized by MRI and audio-vestibular functional tests, such as pure tone audiometry (PTA), electrocochleography (EcoG), caloric test and vestibular evoked myogenic potential (VEMP). METHODS: With a three Tesla magnetic resonance imaging (MRI) unit, 3D-FLAIR imaging was performed 24 hours after intratympanic gadolinium through the tympanic membrance in 32 patients with clinically diagnosed unilateral Meniere's Disease. We visualized the enhanced imaging of perilymphatic space in bilateral cochlea, vestibular and (or) canal, scoring scala tympani and scala vestibule of bilateral cochlear basal turn respectively and measuring the developing area of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem subjectively. PTA, EcoG, caloric test and VEMP were performed. The relationship between the endolymphatic hydrops visualized by MRI and audio-vestibular functional tests were studied. RESULTS: The gadolinium appeared in almost all parts of the perilymph in cochlea, vestibular and (or) canals in all 32 patients' inner ears, so the endolymphatic space was clearly shown on 3D-FLAIR imaging. The scala vestibuli score value between the affected side and the healthy side were statistically significant (Z = 4.309, P < 0.05) . The developing vestibular area between the affected side and the healthy side [(6.04 ± 2.89) mm(2), (8.28 ± 3.04)mm(2)] were statistically significant (t = 3.322, P < 0.05) . Abnormal vestibular evoked myogenic potentials were significantly correlated with the developing vestibular area of the affected side (F = 11.96, P < 0.05) . Abnormal electrocochleography were significantly correlated with scala vestibuli score value of cochlear basal turn in the affected side (Z = 3.17, P < 0.05) . No significant correlation was found between the scala vestibuli score value or the developing vestibular area and caloric test or PTA findings. CONCLUSIONS: 3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrance can discriminate the border between the perilymph and the endolymph and show endolymphatic hydrops. This method may provide radiographic reference for the diagnosis of Meniere's disease. The results of VEMP and electrocochleography might have appropriate correlation with degree of vestibular and cochlear hydrops.


Asunto(s)
Hidropesía Endolinfática/diagnóstico , Gadolinio DTPA , Enfermedad de Meniere/complicaciones , Audiometría de Respuesta Evocada , Audiometría de Tonos Puros , Pruebas Calóricas , Cóclea , Medios de Contraste , Oído Interno , Endolinfa , Hidropesía Endolinfática/complicaciones , Humanos , Imagenología Tridimensional , Inyecciones , Imagen por Resonancia Magnética , Perilinfa , Potenciales Vestibulares Miogénicos Evocados , Vestíbulo del Laberinto
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