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目的:探讨经鼓室内耳钆造影MRI前庭导水管显影率及其临床意义。方法:回顾性分析。纳入2010年2月—2018年1月福建医科大学附属第一医院影像科691例经鼓膜穿刺注射行内耳钆造影MRI的患者造影前后MRI及临床资料，其中男300例、女391例，年龄9～82岁。691例中，531例双侧、160例单侧(共1 222侧)行内耳钆造影。临床表现为眩晕483例、突发性耳聋125例、头晕42例、耳鸣39例、无症状2例，按症状有无进行分组观察。观察患者MRI图像，与造影前相比，造影后前庭导水管区信号升高即判定有显影，否则为无显影；另外，采用目测评分法评价内耳膜迷路是否积水。采用χn 2检验分析眩晕组与非眩晕组、突聋组与非突聋组、耳鸣组与非耳鸣组之间前庭导水管显影发生率是否有差异，应用列联相关系数分析前庭导水管显影与膜迷路积水之间的关系。n 结果:全组691例1 222耳中，26.8%(327/1 222耳)可见膜迷路积水，7.4%(90/1 222耳)可见前庭导水管显影。眩晕组6.0%(56/938耳)可见前庭导水管显影，非眩晕组12.0%(34/284耳)可见显影，差异有统计学意义(χn 2＝11.509, n P0.05)；耳鸣组4.0%(6/149耳)可见前庭导水管显影，非耳鸣组7.9%(85/1 073耳)可见显影，差异无统计学意义(χn 2＝2.880, n P>0.05)。眩晕组30.1%(282/938耳)可见膜迷路积水，非眩晕组15.8%(45/284耳)可见膜迷路积水，差异有统计学意义(χn 2＝22.488, n P0.05). About 30.1%(282/938) vertigo-affected ears and 15.8%(45/284) non-vertigo ears showed endolymphatic hydrops, and the difference was statistically significant(χn 2=22.488, n P<0.01). The visualization was found in 3.1%(10/327)of ears with endolymphatic hydrops and 8.9%(80/895)of ears without endolymphatic hydrops, and the difference was statistically significant(χn 2=12.139, n P<0.01). A negative correlation was found between visualization of vestibular aqueduct and endolymphatic hydrops(n r=-0.099, n P<0.01).n Conclusions:In the gadolinium-contrast MR images of the inner ear after intratympanic injection, gadolinium contrast agent can enter the vestibular aqueduct, and the incidence of visualization is about 7.4%. The vestibular aqueduct can be visualized in the MRI gadolinium images of the inner ear because osseous vestibular aqueduct contains perilymphatic space. The vestibular aqueduct is not visualized in the gadolinium-contrast MR images of the inner ear in patients with endolymphatic hydrops, suggesting that some changes about vestibular aqueduct may be an important part of the pathogenesis of Ménierè's disease or vertigo.