MR imaging of endolymphatic hydrops in Ménière’s disease: not all that glitters is gold

Conte, Giorgio; Russo, F; Calloni, Sonia Francesca; Sina, C.; Barozzi, S.; Berardino, Federica Di; Scola, Elisa; Palumbo, Giovanni; Zanetti, Diego; Triulzi, Fabio

doi:10.14639/0392-100x-1986

Cited by 31 publications

(20 citation statements)

References 30 publications

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“…The specificity of detecting EH using MRI was impaired by reports on EH in healthy volunteers [40]. Although the criteria for judgment of EH may be improved, a blurred border between the positive perilymph and negative endolymph may also contribute to the errors.…”

Section: Indicated Clinical Significance Of Ht 2 W-flair-mzfi For Eh Imagingmentioning

confidence: 99%

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High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

Zou

Chen

et al. 2021

Eur Arch Otorhinolaryngol

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Background It is still challenging to detect endolymphatic hydrops (EH) in patients with Meniere’s disease (MD) using MRI. The aim of the present study was to optimize a sensitive technique generating strong contrast enhancement from minimum gadolinium–diethylenetriamine pentaacetic acid (Gd–DTPA) while reliably detecting EH in the inner ear, including the apex. Materials and methods All imaging was performed using a 3.0 T MR system 24 h after intratympanic injection of low-dose Gd–DTPA. Heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed with magnitude and zero-filled interpolation (hT2W–FLAIR–ZFI) was optimized and validated in phantom studies and compared with medium inversion time inversion recovery imaging with magnitude reconstruction (MIIRMR). The following parameters were used in hT2W–FLAIR–ZFI: repetition time 14,000 ms, echo time 663 ms, inversion time 2900 ms, flip angle 120°, echo train length 271, and field of view 166 × 196 mm2. Results MRI obtained using hT2W–FLAIR–MZFI yielded high-quality images with sharper and smoother borders between the endolymph and perilymph and a higher signal intensity ratio and more homogenous perilymph enhancement than those generated with MIIRMR (p < 0.01). There were predominantly grade II EHs in the cochleae and grade III EHs in the vestibule in definite MD. EH was detected in the apex of 11/16 ipsilateral ears, 3/16 contralateral ears in unilateral definite MD and 3/6 ears in bilateral MD. Conclusions The novel hT2W–FLAIR–MZFI technique is sensitive and demonstrates strong and homogenous enhancement by minimum Gd–DTPA in the inner ear, including the apex, and yields high-quality images with sharp borders between the endolymph and perilymph.

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Section: Indicated Clinical Significance Of Ht 2 W-flair-mzfi For Eh Imagingmentioning

confidence: 99%

“…Improved visualization of the enhancement signal in the cochlear apex provides an excellent tool for thorough evaluation of EH in MD. Theoretically, the novel method may be applied in MRI with intravenous administration of GdC, which is favored by the radiologist [40].…”

Section: Indicated Clinical Significance Of Ht 2 W-flair-mzfi For Eh Imagingmentioning

confidence: 99%

High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

Zou

Chen

et al. 2021

Eur Arch Otorhinolaryngol

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“…Heavily T2-weighted (HT2W) 3D FLAIR images acquired 4 to 5 hours after IV contrast agent administration can assess the membranous labyrinth in adults. 12,13 However, this imaging protocol may not be suitable for infants because of the need for contrast agent injection and to acquire the images during separate sessions. In this study, we describe our experience in depicting the normal anatomy of the membranous labyrinth in a cohort of infants using the HT2W 3D FLAIR sequence with no contrast agent.…”

Section: Methodsmentioning

confidence: 99%

Assessment of the Membranous Labyrinth in Infants Using a Heavily T2-weighted 3D FLAIR Sequence without Contrast Agent Administration

Conte¹,

Casale²,

Caschera³

et al. 2021

AJNR Am J Neuroradiol

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“…Currently, there is a shortage of high-quality studies to compare the visualization of the inner ear between intratympanic and intravenous dosing of GBCA, though general opinion suggests better imaging with the intratympanic approach ( 32 , 33 ). However, the intratympanic method has some restrictions as GBCA is not registered for intratympanic use by national pharmaceutical agencies.…”

Section: Consensus Of the Committeementioning

confidence: 99%

Consensus on MR Imaging of Endolymphatic Hydrops in Patients With Suspected Hydropic Ear Disease (Meniere)

et al. 2022

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Endolymphatic hydrops (EH) is considered the histological hallmark of Meniere's disease. Visualization of EH has been achieved by special sequences of inner ear magnetic resonance imaging (MRI) with a gadolinium-based contrast agent via intravenous or intratympanic administration. Although it has been applied for more than 10 years since 2007, a unified view on this technique has not yet been achieved. This paper presents an expert consensus on MRI of endolymphatic hydrops in the following aspects: indications and contra-indications for patient selection, methods of contrast-agent administration (intravenous or intratympanic), MRI sequence selection, the specific scanning parameter settings, and standard image evaluation methods and their advantages and disadvantages. For each part of this consensus, a comment is attached to elucidate the reasons for the recommendation.

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MR imaging of endolymphatic hydrops in Ménière’s disease: not all that glitters is gold

Cited by 31 publications

References 30 publications

High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

Assessment of the Membranous Labyrinth in Infants Using a Heavily T2-weighted 3D FLAIR Sequence without Contrast Agent Administration

Consensus on MR Imaging of Endolymphatic Hydrops in Patients With Suspected Hydropic Ear Disease (Meniere)

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