Comparison of furosemide-loading cervical vestibular-evoked myogenic potentials with magnetic resonance imaging for the evaluation of endolymphatic hydrops

Shiraishi, Ko; Ohira, Noriko; Kobayashi, Takaaki; Satõ, Mitsuo; Osaki, Yasuhiro; Doi, Kunio

doi:10.1080/00016489.2020.1769863

Cited by 6 publications

(7 citation statements)

References 16 publications

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“…However, there may be some controversy regarding this point, so our choice of the 1995 AAO-HNS diagnostic scale ( 1 ) instead of the criteria of the 2015 Barany Society guidelines ( 27 ) as the main guidelines may represent a limitation of this study. The size of the study population consisting of 123 (246 ears) in our study was much larger than the sample sizes in previous studies of the associations between clinical parameters of MD and EH visualized by MRI ( 19 , 20 , 28 – 33 ).…”

Section: Discussionmentioning

confidence: 87%

“…Although an automated method for measurement of the hydrops ratio from the MRI findings was recently reported and showed considerable agreement with the existing calculation method, this automated measurement is not easy to set up for general clinical practice (39). Instead, the classification described by Nakashima et al 41) have also been adopted for the analysis of EH in MD (28,30); in some instances, these systems cannot be combined with MRI using the HYDROPS protocol. Therefore, the simplified grading system proposed by Nakashima et al ( 21) was used in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies analyzed MRI findings of EH and clinical data ( 19 , 20 , 28 – 31 ). Two Korean studies calculated the mean hydrops ratios in study populations of 29 and 16 patients with unilateral definite MD ( 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…Both studies analyzed correlations between the severity of EH and laboratory parameters, including audiometry, caloric test, cervical VEMP, and electrocochleography (ECoG), and showed that audiometry and caloric test results were correlated with the hydrops ratio, while VEMP and ECoG were not ( 19 , 20 ). Other studies have also examined the correlation of EH with cervical VEMP in patients with unilateral definite MD ( 28 , 29 ). In these studies, EH on MRI was present in 10 of 14 ears ( 29 ) and 12 of 20 ears ( 28 ), and hydrops grade ( 28 ) was correlated with the amplitude of cervical VEMP.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have also examined the correlation of EH with cervical VEMP in patients with unilateral definite MD ( 28 , 29 ). In these studies, EH on MRI was present in 10 of 14 ears ( 29 ) and 12 of 20 ears ( 28 ), and hydrops grade ( 28 ) was correlated with the amplitude of cervical VEMP. In another study, in a population of 78 patients with unilateral definite MD, there were 57 cases of cochlear EH and 60 of vestibular EH, and these were related to the results of audiometry and caloric tests ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

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Correlation of clinical parameters with endolymphatic hydrops on MRI in Meniere's disease

Han

Kim

et al. 2022

Front. Neurol.

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A clinical diagnosis of Ménière's disease (MD) is made based on medical history and audiometry findings. The 1995 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines requires histopathological confirmation of endolymphatic hydrops (EH) for a diagnosis of “certain” MD. Symptoms such as dizziness and ear fullness are important diagnostic features; however, the descriptions provided by patients are frequently vague and non-specific. A recently developed magnetic resonance imaging (MRI) protocol to document EH is, therefore, useful for the evaluation of inner ear status in patients with MD. In this study, patients with MD were assessed using MRI and the HYDROPS (HYbriD of Reversed image Of Positive endolymph signal and native image of positive perilymph Signal) protocol to investigate the effectiveness of MRI for visualization of the endolymphatic space in the diagnosis of MD by correlating clinical laboratory parameters with the grade of EH. Of the 123 patients with MD recruited in this study, 80 had definite MD, 11 had probable MD, and 32 had possible MD based on the 1995 AAO-HNS guidelines. The EH grade based on HYDROPS MRI was determined independently by two otorhinolaryngologists and compared with several clinical parameters, including the diagnostic scale of MD (1995 AAO-HNS guidelines), pure tone average (PTA), low tone average (LTA), canal paresis (CP) on the caloric test, and disease duration. Cochlear hydrops and vestibular hydrops were detected in 58 and 80% of 80 definite MD ears, in 33 and 58% of 12 probable MD ears, and in 5 and 27% of 37 possible MD ears, respectively. The proportion of higher hydrops grades increased significantly with grade according to the MD diagnostic scale (p < 0.0001). Both PTA and LTA were significantly higher in patients with hydrops grade 2 than hydrops grade 0 in both the cochlea and the vestibule. CP was significantly higher in patients with grade 2 than grade 0 vestibular hydrops. Disease duration was not associated with hydrops grade. Radiological evaluation of MD using the HYDROPS protocol is useful for evaluation of the extent and severity of EH in the diagnosis of MD based on its pathophysiological mechanism.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Correlation of clinical parameters with endolymphatic hydrops on MRI in Meniere's disease

Han

Kim

et al. 2022

Front. Neurol.

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Delayed post gadolinium MRI descriptors for Meniere’s disease: a systematic review and meta-analysis

et al. 2023

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Objectives Delayed post-gadolinium magnetic resonance imaging (MRI) detects changes of endolymphatic hydrops (EH) within the inner ear in Meniere’s disease (MD). A systematic review with meta-analysis was conducted to summarise the diagnostic performance of MRI descriptors across the range of MD clinical classifications. Materials and methods Case-controlled studies documenting the diagnostic performance of MRI descriptors in distinguishing MD ears from asymptomatic ears or ears with other audio-vestibular conditions were identified (MEDLINE, EMBASE, Web of Science, Scopus databases: updated 17/2/2022). Methodological quality was evaluated with Quality Assessment of Diagnostic Accuracy Studies version 2. Results were pooled using a bivariate random-effects model for evaluation of sensitivity, specificity and diagnostic odds ratio (DOR). Meta-regression evaluated sources of heterogeneity, and subgroup analysis for individual clinical classifications was performed. Results The meta-analysis included 66 unique studies and 3073 ears with MD (mean age 40.2–67.2 years), evaluating 11 MRI descriptors. The combination of increased perilymphatic enhancement (PLE) and EH (3 studies, 122 MD ears) achieved the highest sensitivity (87% (95% CI: 79.92%)) whilst maintaining high specificity (91% (95% CI: 85.95%)). The diagnostic performance of “high grade cochlear EH” and “any EH” descriptors did not significantly differ between monosymptomatic cochlear MD and the latest reference standard for definite MD (p = 0.3; p = 0.09). Potential sources of bias were case-controlled design, unblinded observers and variable reference standard, whilst differing MRI techniques introduced heterogeneity. Conclusions The combination of increased PLE and EH optimised sensitivity and specificity for MD, whilst some MRI descriptors also performed well in diagnosing monosymptomatic cochlear MD. Key Points • A meta-analysis of delayed post-gadolinium magnetic resonance imaging (MRI) for the diagnosis of Meniere’s disease is reported for the first time and comprised 66 studies (3073 ears). • Increased enhancement of the perilymphatic space of the inner ear is shown to be a key MRI feature for the diagnosis of Meniere’s disease. • MRI diagnosis of Meniere’s disease can be usefully applied across a range of clinical classifications including patients with cochlear symptoms alone.

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Association of cervical vestibular-evoked myogenic potential tuning property test results with MRI findings of endolymphatic hydrops in Meniere’s disease

Murofushi

Tsubota

Kanai

et al. 2020

Eur Arch Otorhinolaryngol

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Comparison of furosemide-loading cervical vestibular-evoked myogenic potentials with magnetic resonance imaging for the evaluation of endolymphatic hydrops

Cited by 6 publications

References 16 publications

Correlation of clinical parameters with endolymphatic hydrops on MRI in Meniere's disease

Correlation of clinical parameters with endolymphatic hydrops on MRI in Meniere's disease

Delayed post gadolinium MRI descriptors for Meniere’s disease: a systematic review and meta-analysis

Association of cervical vestibular-evoked myogenic potential tuning property test results with MRI findings of endolymphatic hydrops in Meniere’s disease

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