Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection, and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops

Gu, Xiaosong; Zm, Fang; Y, Liu; Lin, Shaofu; Han, Bin; Zhang, R; Chen, X

doi:10.1017/s0022215113003289

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…Particularly in the case of contralateral DEH, it is difficult to identify the existence of ELH or which ear, or even which region (cochlea or vestibule or both) has ELH on the basis of vestibular functional testing, such as caloric testing and cVEMP, alone. In a previous report, these forms of vestibular testing provided only limited evidence for the diagnosis of DEH [11]. The direction of the nystagmus is useful for estimation of the affected side; however, we are not always able to observe the nystagmus in patients at the time of a vertigo attack.…”

Section: Discussionmentioning

confidence: 94%

Bilateral delayed endolymphatic hydrops evaluated by bilateral intratympanic injection of gadodiamide with 3T-MRI

et al. 2018

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The purpose of this study was to assess the diagnostic performance of 3T MRI after intratympanic injection of gadodiamide for delayed endolymphatic hydrops (DEH), and assess the relationship between endolymphatic hydrops (ELH) and vestibular function in patients diagnosed with DEH and confirmed by 3T MRI. Nineteen patients clinically diagnosed with DEH (11 ipsilateral DEH, 8 contralateral DEH) participated in this study. Diluted gadodiamide was administered to the bilateral tympanic cavity by injection through the tympanic membrane. At 24 hours post-injection, the ELH was evaluated by MRI. Patient vestibular functions were evaluated by caloric testing and cVEMP. ELH was observed in all patients (19/19: positive rate 100%). The distribution patterns of ELH varied between the cochlear or vestibular region. Vestibular ELH was observed in the affected ear in all ipsilateral DEH patients. In the contralateral DEH patients, however, there were individual differences in the distribution patterns of ELH. Six patients (1 ipsilateral DEH, 5 contralateral DEH) had bilateral ELH. No obvious relationships were observed between ELH and vestibular function. ELH distribution was complicated, particularly in the contralateral DEH cases. It was difficult to identify the existence of ELH by vestibular functional testing alone; therefore, 3T MRI is thought to be useful for identifying the affected ear. A significant number of cases had “bilateral” DEH, particularly among the contralateral DEH cases, indicating that we should pay careful attention to this pathology when treating DEH.

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Section: Discussionmentioning

confidence: 94%

Bilateral delayed endolymphatic hydrops evaluated by bilateral intratympanic injection of gadodiamide with 3T-MRI

et al. 2018

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“…The results of the studies included in our systematic review give comparable results for the sensitivity of MRI with intratympanic gadolinium administration (19)(20)(21)28,29).…”

Section: Discussionmentioning

confidence: 71%

“…Accordingly, this method can be recommended in patients with a poor uptake of gadolinium through the round window and an estimated glomerular filtration rate exceeding 60 mL/min/1.73 m 2 , since gadolinium can result in nephrogenic systemic fibrosis after intravenous administration (33)(34)(35). The sensitivity to detect endolymphatic hydrops for other diagnostic tools, such as vestibular-evoked myogenic potential (52%) and bithermal caloric testing (72%), were lower compared with MRI with intratympanic gadolinium administration (29). Therefore, these tests were not recommended as alternative in patients with a poor permeability of gadolinium.…”

Section: Discussionmentioning

confidence: 99%

Click Stimulus Electrocochleography Versus MRI With Intratympanic Contrast in Ménière's Disease

Ziylan

Smeeing²,

Stegeman³

et al. 2016

Otology &Amp; Neurotology

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Objective: To evaluate the diagnostic value of electrocochleography compared with magnetic resonance imaging (MRI) with intratympanic gadolinium administration to diagnose endolymphatic hydrops in patients with Ménière's disease. Data Sources: An electronic search was performed in the PubMed, EMBASE, and Cochrane databases on September 15, 2015. A systematic search was conducted. Articles were included if written in English, Dutch, German, or French language. Study Selection: Original studies reporting on the diagnostic value of electrocochleography compared with MRI with intratympanic gadolinium administration, were included. Data Extraction: The methodological quality of the studies was independently assessed by two reviewers using an adjusted version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. The results of the diagnostic values of both tests were extracted.Data Synthesis: We performed analyses for the sensitivity, specificity, positive predictive value, and negative predictive value of compared electrocochleography with MRI with intratympanic gadolinium administration in patients with definite Ménière's disease. Conclusion: The results of this systematic review, based on a very low number of patients, show there is a relative low sensitivity and negative predictive value for click stimulus electrocochleography compared with MRI with intratympanic gadolinium administration for detecting endolymphatic hydrops in patients with definite Ménière's disease.

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“…Diagnosis of patients with DEH cannot be performed by routine high-resolution MRI hydrography of the inner ear individually [11]. Hence, the use of 3-dimensional fluid-attenuated inversion recovery (FLAIR) MRI following transtympanic gadolinium injection as a modality to identify the endolymphatic hydrops is described in various studies [11, 23]. Also, intratympanic injection of gadolinium-diethylenetriamine penta-acetic acid dimeglumine solution was administered in these studies.…”

Section: Discussionmentioning

confidence: 99%

“…There might be other symptoms, including tinnitus and ear fullness in DEH [8,9]. There are various types of DEH including ipsilateral, contralateral, and bilateral [10][11][12]. Hence, the proper diagnosis of the ear that causes vestibular symptoms in these patients is remarkably essential.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Patients with Delayed Endolymphatic Hydrops by Videonystagmography, Vestibular-Evoked Myogenic Potentials, and Electrocochleography

Yazdani

Rahmaty

Mousavi

et al. 2021

ORL

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Introduction: The categorization of delayed endolymphatic hydrops (DEH) based on the ear which produces vertigo may sometimes cause misdiagnosis. Objectives: The aim of this study was investigating the vestibular-evoked myogenic potentials (VEMPs), electrocochleography (ECoG), and videonystagmography (VNG) in cases with DEH to determine the ear that originates symptoms. Methods: In this cross-sectional study, 34 patients – 20 males and 14 females – with profound unilateral sensorineural deafness and vertigo attacks were recruited and evaluated by the ECoG, VNG, and VEMPs tests. Results: The average age was around 43; the summating potential/action potential was abnormal in 29.4% of patients in their normal auditive ear. In 32.4, 17.6, and 50% of cases with a deaf ear, absent, normal, and abnormal VEMPs results were sequentially observed, respectively. In normal-hearing ears, absent, normal, and abnormal VEMPs were observed in 23.5, 50, and 26.5%, respectively. In the normal-hearing ear, the distribution of abnormal VEMPs was 26.5%, and in the deaf ear, this parameter was abnormal in 50% of the opposite ear (p value = 0.00021). In the VNG test, among patients with a normal-hearing ear, results in 27 and 7 patients were sequentially normal and hypofunction. Conclusion and Significance: The probability of a hypofunction VNG test in a normal-hearing ear might be greater when the VEMPs results of the contralateral deaf ear are normal. In patients with a normal-hearing ear, the distribution of abnormal VEMPs in the contralateral deaf ear is greater, although the intact side may also manifest abnormality in VEMPs tests. The initial evaluation should begin in a deaf ear as well as for the normal-hearing ear ere utilizing ablation surgery.

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Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection, and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops

Abstract: Three-dimensional magnetic resonance imaging after intratympanic injection of gadolinium is valuable in the diagnosis of delayed endolymphatic hydrops and its classification. The perilymphatic space scoring system improved the diagnostic accuracy of magnetic resonance imaging.

Cited by 9 publications

References 14 publications

Bilateral delayed endolymphatic hydrops evaluated by bilateral intratympanic injection of gadodiamide with 3T-MRI

Bilateral delayed endolymphatic hydrops evaluated by bilateral intratympanic injection of gadodiamide with 3T-MRI

Click Stimulus Electrocochleography Versus MRI With Intratympanic Contrast in Ménière's Disease

Evaluation of Patients with Delayed Endolymphatic Hydrops by Videonystagmography, Vestibular-Evoked Myogenic Potentials, and Electrocochleography

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