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Characteristic MR findings suggesting presumed labyrinthine hemorrhage
Dong Sun Kim1, Dong Woo Park1, Tae Yoon Kim1
1a Department of Radiology , Hanyang University Guri Hospital , Guri , Korea.
Objectives:
To evaluate the magnetic resonance imaging (MRI) findings of labyrinthine hemorrhage as a cause of sudden sensorineural hearing loss (SSNHL).
Methods:
MRI scans of 59 patients with SSNHL were retrospectively analyzed and compared to clinical features and audiometry data. MR images included pre-enhanced T1-weighted, 3D FLAIR volume isometric turbo spin-echo acquisition (VISTA), post-enhanced T1-weighted and 4-h-delayed enhanced FLAIR VISTA, and 3D thin-section proton density-weighted images.
Results:
High labyrinth signals were seen on pre-enhanced T1-weighted and 3D FLAIR VISTA images with no enhancement for 6 of 59 (10.2%) patients with SSNHL. In these six patients with presumed inner-ear hemorrhage, high signal intensity was seen in the endolymphatic and perilymphatic portions of the labyrinth on T1-weighted and 3D FLAIR VISTA images. In patients with SSNHL with nonhemorrhagic causes such as vestibular schwannoma or labyrinthitis, high signal or labyrinthine enhancement was seen only in the perilymphatic portion of the labyrinth on pre- or post-enhanced 3D FLAIR VISTA images.
Conclusions:
MRI using pre-enhanced T1-weighted, 3D FLAIR VISTA, and post-enhanced T1-weighted, 4-h delayed enhanced FLAIR VISTA images is able to identify labyrinthine hemorrhage as the cause of SSNHL. High signals in both the endolymphatic and perilymphatic portions of the labyrinth on pre- or post-enhanced 3D FLAIR VISTA images without enhancement indicate labyrinthine hemorrhage.
Insights
Magnetic resonance imaging (MRI) can identify labyrinthine hemorrhage, a cause of sudden sensorineural hearing loss (SSNHL). Specific MRI sequences show high signals in the inner ear, indicating hemorrhage.
Area of Science:
- Radiology
- Otolaryngology
- Neurology
Background:
- Sudden sensorineural hearing loss (SSNHL) is a critical condition requiring prompt diagnosis.
- Labyrinthine hemorrhage is a potential, though often undiagnosed, cause of SSNHL.
- Advanced magnetic resonance imaging (MRI) techniques may offer diagnostic insights.
Purpose of the Study:
- To evaluate the utility of specific MRI sequences in identifying labyrinthine hemorrhage.
- To correlate MRI findings with clinical and audiometric data in patients with SSNHL.
Main Methods:
- Retrospective analysis of MRI scans from 59 patients diagnosed with SSNHL.
- Utilized pre- and post-contrast T1-weighted, 3D FLAIR VISTA, and delayed enhanced FLAIR VISTA sequences.
- Compared imaging findings with clinical presentations and audiometry results.
Main Results:
- Labyrinthine hemorrhage was identified in 6 out of 59 (10.2%) patients with SSNHL.
- High signal intensity in both endolymphatic and perilymphatic spaces on T1-weighted and 3D FLAIR VISTA images indicated hemorrhage.
- Non-hemorrhagic causes showed high signals or enhancement only in the perilymphatic space.
Conclusions:
- MRI, particularly using pre-enhanced T1-weighted and 3D FLAIR VISTA sequences, is effective in diagnosing labyrinthine hemorrhage as a cause of SSNHL.
- The presence of high signals in both endolymphatic and perilymphatic labyrinthine portions without enhancement is a key indicator of labyrinthine hemorrhage.
