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

( views:553, downloads:0 )
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
Volume 46, Issue 10, 2012
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.

  • [1]Berlinger NT.Meniere' s disease: new concepts, new treatments.Minn Med,2011,94:33-36.
  • [2]Sajjadi H,Paparella MM. Meniere's disease. Lancet,2008,372:406-414.
  • [3]Warmerdam TJ,Schr(o)der FH,Wit HP,et al.Perilymphatic and endolymphatic pressures during endolymphatic hydrops.Eur Arch Otorhinolaryngo1,2003,260:9-11.
  • [4]中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.梅尼埃病的诊断依据和疗效评估.中华耳鼻咽喉头颈外科杂志,2007,42:163.
  • [5]Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière' s disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc.Otolaryngol Head Neck Surg,1995,113:181-185.
  • [6]黄耀渠,赵晓梅,秦红卫,等.磁共振3 D-CISS序列诊断梅尼埃病的价值和限度.放射学实践,2010.25:293-296.
  • [7]肖虎,陈宏,刘文亚.3T MRI容积再现技术在诊断感音神经性耳聋中的价值.中华放射学杂志,2011,45:689-691.
  • [8]Salt AN,Ma Y.Quantification of solute entry into cochlear perilymph through the round window membrane.Hear Res,2001,154:88-97.
  • [9]Zou J,Pyykk(o) I,Bjelke B,et al. Communication between the perilymphatic scalae and spiral ligament visualized by in vivo MRI.Audiol Neurotol,2005,10:145-152.
  • [10]Kawai H,Naganawa S,Ishihara S,et al.MR imaging of the cochlear modiolus after intratympanic administration of GdDTPA.Magn Reson Med Sci,2010,9:23-29.
  • [11]Nakashima T,Naganawa S,Sugiura M,et al.Visualization of endolymphatic hydrops in patients with Meniere' s disease.Laryngoscope,2007,117:415-420.
  • [12]刘芳,余力生,黄魏宁,等.梅尼埃病的内淋巴积水显像.中华耳鼻咽喉头颈外科杂志,2010,45:324-327.
  • [13]Naganawa S,Satake H,Iwano S,et al.Imaging endolymphatic hydrops at 3 tesla using 3D-FLAIR with intranic Gd-DTPA administration.Magn Reson Med Sci,2008,7:85-91.
  • [14]Naganawa S,Sone M,Yamazaki M,et al.Visualization of endolymphatic hydrops after intratympanic injection of Gd-DTPA:comparison of 2D and 3D real inversion recovery imaging.Mngn Reson Med Sci,2011,10:101-106.
  • [15]Melhem ER,Shakir H,Bakthavachalam S,et al. Inner ear volumetric measurements using high-resolution 3D T2-weighted fast spin-echo MR imaging: initial experience in healthy subjects.AJNR Am J Neuroradiol,1998,19:1819-1822.
  • [16]李书玲,刘怀军,池琛,等.正常人内耳前庭、半规管及耳蜗的MRI测量.中华放射学杂志,2003,37:55-58.
  • [17]Fiorino F,Pizzini FB,Beltramello A,et al.MRI performed after intratympanic gadolinium administration in patients with Ménière's disease: correlation with symptoms and signs.Eur Arch Otorhinolaryngol,2011,268:181-187.
  • [18]Hallpike CS,Carins H.Observations on the Pathology of Ménière's Syndrome:(Section of Otology).Proc R Soc Med,1938,31:1317-1336.
  • [19]Yoshioka M,Naganawa S,Sone M,et al.Individual differences in the permeability of the round window:evaluating the movement of intratympanic gadolinium into the inner ear.Otol Neurotol,2009,30:645-648.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn