Three‐dimensional (3D) visualization of endolymphatic hydrops after intratympanic injection of Gd‐DTPA: Optimization of a 3D‐real inversion‐recovery turbo spin‐echo (TSE) sequence and application of a 32‐channel head coil at 3T

Abstract

Purpose:To enable volume visualization of endolymphatic hydrops of Ménière's disease via a volume rendering (VR) technique, a three‐dimensional (3D) inversion‐recovery (IR) sequence with real reconstruction (3D‐real IR) sequence after intratympanic injection of Gd‐DTPA was optimized for higher spatial resolution using a 32‐channel head coil at 3T.Materials and Methods:Pulse sequence parameters were optimized using a diluted Gd‐DTPA phantom. Then, 11 patients who had been clinically diagnosed with Ménière's disease and a patient with sudden hearing loss were scanned. Images were processed using commercially available 3D‐VR software. 3D‐real IR data was processed to produce endolymph and perilymph fluid volume images in different colors. 3D‐CISS data was processed to generate total fluid volume images.Results:While maintaining a comparable signal‐to‐noise ratio (SNR) and scan time, the voxel volume could be reduced from 0.4 × 0.4 × 2 mm3 with a 12‐channel coil to 0.4 × 0.4 × 0.8 mm3 with a 32‐channel coil. A newly‐optimized protocol allowed the smooth, three‐dimensional visualization of endolymphatic hydrops in all patients with Ménière's disease.Conclusion:Volumetrically separate visualization of endo‐/perilymphatic space is now feasible in patients with Ménière's disease using an optimized 3D‐real IR sequence, a 32‐channel head coil, at 3T, after intratympanic administration of Gd‐DTPA. This will aid the understanding of the pathophysiology of Ménière's disease. J. Magn. Reson. Imaging 2010;31:210–214. © 2009 Wiley‐Liss, Inc.

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

“…All patients underwent 3T MR imaging of the temporal bone by using a 32-channel phased array coil to rule out schwannoma or other causes of the symptoms. Following a delay of 4 hours after intravenous contrast administration (Gadovist; BayerSchering Pharma, Berlin, Germany; 1.0 mmol/mL at a dose of 0.2 mmol/kg), a 3D real inversion recovery (3D-IR) sequence 13 The MR images were qualitatively analyzed by 2 experienced neuroradiologists (K.B. and B.S.)…”

“…Since the first publication of MR imaging visualization of EH in an animal study in 2001 15 and MR imaging demonstration of EH in patients with MD following intratympanic injection in 2007, 16 numerous studies have tried to visualize EH by using different routes of administration of contrast media, such as intratympanic 16 versus intravenous [17][18][19][20] and by altering intravenous dosage regimens (single, 13,17 24 and 3D-IR sequences. 13 On the basis of previous demonstration of the feasibility to separate the endoand perilymphatic space 24 hours after intratympanic gadolinium injection by a 3D-IR sequence 13 and the observation that perilymphatic enhancement occurs 4 hours after intravenous contrast administration, 21,25 our protocol comprised a 3D-IR sequence obtained 4 hours following intravenous injection of contrast media.…”

“…5 Histopathology has provided evidence that not every individual with EH presents with symptoms of MD [6][7][8] and not every individual with the clinical diagnosis of MD has EH. [9][10][11][12] Only recently has MR imaging enabled depiction of EH, 13 opening a window for in vivo confirmation of EH. The purpose of our study was to assess the degree of EH in 53 patients with MD and to correlate the MR imaging findings obtained by a specific protocol with the certitude of clinical diagnosis.…”

Visualization of Endolymphatic Hydrops after Intratympanic Injection of Gd-DTPA: Comparison of 2D and 3D Real Inversion Recovery Imaging

“…Because of the complexity of the labyrinthine structure, 3D real IR and 32-channel head coil at 3T have been used for 3D visualization of endo-/perilymph space. 6 The previously reported 3D real IR method using 3D turbo spin echo (3D TSE) requires 15 minutes' scan time. 5,6 Wider use of the method will require shorter scan time.…”

“…6 The previously reported 3D real IR method using 3D turbo spin echo (3D TSE) requires 15 minutes' scan time. 5,6 Wider use of the method will require shorter scan time. Software limitations of diŠerent manufacturers' scanners sometimes make it di‹-cult to duplicate the 3D real IR protocol.…”