Diagnostic value of three-dimensional fluid-attenuated inversion recovery MR imaging after intratympanic administration of contrast media in Meniere's disease

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Author:
SHI Hong-lu(Shandong Medical Imaging Research Institute ,School of Medicine, Shandong University ,Jinan 250012, China)
ZHANG Dao-gong()
WANG Guang-bin(Shandong Medical Imaging Research Institute ,School of Medicine, Shandong University ,Jinan 250012, China)
FAN Zhao-min()
BAI Xue(Shandong Medical Imaging Research Institute ,School of Medicine, Shandong University ,Jinan 250012, China)
GUO Li-jun(Shandong Medical Imaging Research Institute ,School of Medicine, Shandong University ,Jinan 250012, China)
MAN Xiao-ni(Shandong Medical Imaging Research Institute ,School of Medicine, Shandong University ,Jinan 250012, China)
Journal Title:
Chinese Journal of Radiology
Issue:
Volume 46, Issue 10, 2012
DOI:
10.3760/cma.j.issn.1005-1201.2012.10.003
Key Word:
Meniere's disease; Endolymphatic hydrops; Magnetic resonance imaging

Abstract: Objective After intratympanic gadolinium administration through the tympanic membrane,three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) was performed to evaluate endolymphatic visualization and its diagnostic value in Meniere's disease.Methods Twenty-four hours after intratympanic gadolinium administration through the tympanic membrane,19 patients with unilateral Meniere's disease diagnosed clinically underwent 3D-FLAIR and 3D-Balance-FFE imaging at 3.0 T MR scanner.The enhanced imaging of perilymphatic space in bilateral cochlea,vestibular and (or) canal were observed.Scala tympani and scala vestibule of bilateral cochlear basal turn were scored respectively.The enhanced range of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem were measured. Wilcoxon tests and paired t tests were used.Results The gadolinium appeared in almost all parts of the perilymph in cochlea,vestibular and (or) canal,so the endolymphatic space was clearly visualized on 3D-FLAIR imaging.The score of scala vestibuli between the affected side (3 cases scored 2,9 cases scored 1,7 cascs scored 0) and the healthy side ( 15 cases scored 2,2 cases scored 1,2 cases scored 0 ) were significantly different ( U =3.090,P < 0.05 ).The area of enhanced vestibular were (5.77 ± 2.33) mm2 and (8.11 ± 3.32) mm2 for the affected side and the healthy side,which were significantly different ( U =3.090,P < 0.05 and t =2.638,P < 0.05 ).Conclusions According to 3D-Balance-FFE MRI and the enhancement of perilymphatic space,3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrance can be used to show the border between the perilymph and the endolymph and confirm endolymphatic hydrops,thus providing radiographic evidence for the diagnosis of Meniere's disease.

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