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Published on: January 22, 2010
3D-real IR MRI of Meniere's disease with partial endolymphatic hydrops
Suming Shi1, Feng Zhou2, Wuqing Wang1
1ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Fenyang Road No. 83, Shanghai 200031, China; Key Laboratory of Hearing Medicine of National Health and Family Planning Commission (NHFPC), Fenyang Road No. 83, Shanghai 200031, China.
Objectives:
A three-dimensional inversion-recovery sequence with real reconstruction (3D-real IR) sequence 4 h after intravenous gadolinium injection (IV) has been used to visualize the endolymphatic hydrops (ELH) in Meniere's disease (MD). This study was designed to explore the pathology of MD with partial ELH.
Methods:
We collected 338 patients with definite MD, all of whom underwent the IV method. Patients who were found to have partial ELH (vestibular or cochlear) were enrolled. The hearing thresholds of the enrolled patients were analyzed, the regions of interest of the cochlear perilymph and the cerebellum white matter were determined, and the signal intensity ratio in the former to the latter (CC ratio) for both sides in the patients was subsequently evaluated.
Results:
Of the 338 collected patients with definite MD, 19 patients (5.6%) had unilateral vestibular ELH (N = 18) or cochlear ELH (N = 1), and 4 patients (1.2%) with bilateral ELH had contralateral cochlear ELH. The CC ratio of the affected side (1.44 ± 0.46) was higher than that of the unaffected side (1.15 ± 0.33, P < 0.05) in the 19 patients with unilateral ELH. Conversely, there was no difference between the ratio of the contralateral side (1.18 ± 0.16) and the unaffected side (P > 0.05) in the 4 patients with bilateral ELH.
Conclusions:
Partial vestibular ELH was more common than partial cochlear ELH in MD. Moreover, vestibular ELH, rather than cochlear ELH, may correlate with the elevated contrast effect in the affected side, which may better reflect the pathologic mechanism of MD.
Insights
Partial vestibular endolymphatic hydrops (ELH) is more common in Meniere
Area of Science:
- Neurology
- Radiology
- Otolaryngology
Background:
- Meniere's disease (MD) is characterized by endolymphatic hydrops (ELH).
- Three-dimensional inversion-recovery (3D-real IR) with gadolinium injection visualizes ELH.
- Understanding partial ELH is crucial for MD pathology.
Purpose of the Study:
- To investigate the pathology of Meniere's disease (MD) presenting with partial endolymphatic hydrops (ELH).
- To analyze the correlation between hearing thresholds and imaging findings in partial ELH.
- To explore the differences between vestibular and cochlear ELH in MD.
Main Methods:
- 338 patients with definite Meniere's disease (MD) underwent 3D-real IR with gadolinium injection.
- Patients with partial endolymphatic hydrops (ELH) were selected for analysis.
- Cochlear-to-cerebellum signal intensity ratio (CC ratio) was calculated for affected and unaffected sides.
Main Results:
- Partial ELH was identified in 6.8% of MD patients (unilateral: 5.6%, bilateral: 1.2%).
- Unilateral vestibular ELH was more frequent than cochlear ELH.
- The CC ratio was significantly higher in the affected side for unilateral vestibular ELH.
Conclusions:
- Partial vestibular ELH is more prevalent than partial cochlear ELH in Meniere's disease.
- Vestibular ELH, not cochlear ELH, may correlate with enhanced contrast effects, suggesting a role in MD pathology.
- These findings offer insights into the underlying mechanisms of Meniere's disease.
