Comparison of Contrast Effect on the Cochlear Perilymph after Intratympanic and Intravenous Gadolinium Injection

Yamazaki, Masahiro; Naganawa, Shinji; Tagaya, Mitsuhiko; Kawai, Hisashi; Ikeda, Mitsuru; Sone, Michihiko; Teranishi, Masaaki; Suzuki, Hirokazu; Nakashima, Tsutomu

doi:10.3174/ajnr.a2821

Cited by 66 publications

(52 citation statements)

References 32 publications

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“…In accordance with others, 24,28 gadolinium uptake was more pronounced in symptomatic compared with asymptomatic ears in patients with unilateral EH in 90% of our cases (Fig 4).…”

Section: Mr Imaging Visualization Of Ehsupporting

confidence: 77%

“…The intravenous route of contrast administration is also less invasive and renders perilymph enhancement independent of the status of the round window membrane. 26,27 In a comparative study in patients with MD, however, 28 intratympanic contrast injection provided higher perilymphatic signal compared with intravenous administration. An additional advantage of the intravenous method is simultaneous examination of both labyrinths because provided the disease manifestation is unilateral, the nondiseased ear serves for comparison.…”

Section: Mr Imaging Visualization Of Ehmentioning

confidence: 99%

See 1 more Smart Citation

Detection and Grading of Endolymphatic Hydrops in Menière Disease Using MR Imaging

Baráth¹,

Schuknecht²,

Naldi

et al. 2014

AJNR Am J Neuroradiol

193

171

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“…In accordance with others, 24,28 gadolinium uptake was more pronounced in symptomatic compared with asymptomatic ears in patients with unilateral EH in 90% of our cases (Fig 4).…”

Section: Mr Imaging Visualization Of Ehsupporting

confidence: 77%

Section: Mr Imaging Visualization Of Ehmentioning

confidence: 99%

Detection and Grading of Endolymphatic Hydrops in Menière Disease Using MR Imaging

Baráth¹,

Schuknecht²,

Naldi

et al. 2014

AJNR Am J Neuroradiol

193

171

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show abstract

“…[1][2][3][4] Compared with intratympanic gadolinium injection, 3D-FLAIR MR imaging after IV gadolinium injection is less invasive and enables observation of the bilateral cochleae and other inner ear structures. 5 The signal-intensity ratio of the inner ear to other parts of the brain allows semiquantitative expression of the signal intensity and may be useful for comparing results among patients or among ears. Recent articles have reported that the signal-intensity ratio of the inner ear and other parts of the brain is useful in patients with sudden deafness, Ménière disease, and vestibular schwannoma.…”

mentioning

confidence: 99%

Comparison of Inner Ear Contrast Enhancement among Patients with Unilateral Inner Ear Symptoms in MR Images Obtained 10 Minutes and 4 Hours after Gadolinium Injection

Kim¹,

Park²,

Lee

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Recently 4-hour delayed-enhanced 3D-FLAIR MR imaging has been used in pathophysiologic analysis of the inner ear in many auditory diseases, including sudden sensorineural hearing loss, but comparison among different time points is not clear in patients with unilateral inner ear symptoms. We compared the signal-intensity ratios of the inner ears in patients with unilateral inner ear symptoms on 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images after IV gadolinium injection.

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“…Gadolinium, an agent used in magnetic resonance imaging (MRI), is taken up into the perilymph, presumably via perfusion through the BLB, specifically through the blood-perilymphatic barrier. Increased gadolinium enhancement in the perilymph on the ipsilaterally inner ear affected with Meniere's disease has been noted in multiple studies, indicative of breakdown of the BLB [36][37][38][39] . Of note, in the study of Tagaya et al 37 , a high signal intensity ratio correlated with a higher grade (none, mild, or significant) of hydrops in both the cochlea and the vestibule 37 .…”

Section: Discussionmentioning

confidence: 99%

Recent Research Trend for Ménièreʼs Disease

Nam¹

2017

Res Vestib Sci

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The ultrastructural organization of the blood labyrinthine barrier (BLB) was investigated in the human vestibular endorgan, the utricular macula, using postmortem specimens from individuals with documented normal auditory and vestibular function and surgical specimens from patients with intractable Meniere's disease. Transmission electron microscopic analysis of capillaries located in the normal human utricular stroma showed vascular endothelial cells with few pinocytotic vesicles, covered by a smooth and uniform basement membrane surrounded by pericyte processes. Meniere's disease specimens revealed differential ultrastructural pathological changes in the cellular elements of the microvasculature. With moderate degeneration of the BLB, there were numerous vesicles within the vascular endothelial cells (VECs), with increased numbers at the abluminal face, pericyte process detachment and disruption of the perivascular basement membrane surrounding the VECs. With severe degeneration of the BLB, there was severe vacuolization or frank apparent necrosis of VECs and loss of subcellular organelles. A higher severity of BLB degenerative changes was associated with a higher degree of basement membrane thickening and edematous changes within the vestibular stroma. This study presents the first ultrastructural analysis of the capillaries constituting the BLB in the human vestibular macula utricle from normal and Meniere's disease.In the inner ear, the term blood labyrinthine barrier (BLB) refers to the barrier between the vasculature and the inner ear fluids, either endolymph or perilymph 1, 2 . The BLB is critical for the maintenance of the inner ear fluid ionic homeostasis and for the prevention of the entry of deleterious substances into the inner ear 3 . By studying the penetration of dyes and drugs from the systemic circulation into the fluids of the inner ear, it can be shown that the BLB is selective and that the composition of the inner ear fluids is regulated and markedly different from that of blood or of other fluids such as cerebrospinal fluid 2 . Understanding the dynamics of the BLB is important to develop therapeutic drug delivery systems to the inner ear to block or enhance the BLB inflammatory response. The BLB in the cochlea is well studied in animal models 2,4,5 . Initial transmission electron microscopy (TEM) studies demonstrated that the BLB in the guinea pig stria vascularis and spiral ligament is composed of vascular endothelial cells (VECs) surrounded by a basement membrane 6 . More recent studies have noted that, in addition, the intrastrial BLB is composed of pericytes and perivascular-resident macrophage-like melanocytes [7][8][9][10][11] . The VECs line the interior surface of the blood vessels, connected by tight junctions, forming an interface between circulating blood and the rest of the vessel wall. Pericytes are the only cell type to intimately connect with VECs as they lie embedded within the endothelial basement membrane. The perivascular-resident macrophage-like melanocytes have foot pr...

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Comparison of Contrast Effect on the Cochlear Perilymph after Intratympanic and Intravenous Gadolinium Injection

Cited by 66 publications

References 32 publications

Detection and Grading of Endolymphatic Hydrops in Menière Disease Using MR Imaging

Detection and Grading of Endolymphatic Hydrops in Menière Disease Using MR Imaging

Comparison of Inner Ear Contrast Enhancement among Patients with Unilateral Inner Ear Symptoms in MR Images Obtained 10 Minutes and 4 Hours after Gadolinium Injection

Recent Research Trend for Ménièreʼs Disease

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