Inner Ear Enhancement With Delayed 3D-FLAIR MRI Imaging in Vestibular Schwannoma
Andrew J Bowen1, Matthew L Carlson1, John I Lane2
1Department of Otolaryngology-Head and Neck Surgery.
Objectives:
To evaluate blood-labyrinth barrier permeability using delayed gadolinium enhanced three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) in patients with untreated sporadic vestibular schwannoma (VS) to interrogate the etiopathogenesis of progressive sensorineural hearing loss.
Design:
Prospective case series.
Setting:
Single institution tertiary care center.
Participants:
Patients with previously untreated small to medium-sized unilateral VS undergoing 3D-FLAIR imaging 10 minutes (immediate) and 5 to 8 hours (delayed) after administration of intravenous gadolinium.
Main Outcome Measures:
Comparison of cochlear and vestibular signal intensity ratios (SIRs) across immediate and delayed images and across the tumor and nontumor ear.
Results:
Six of eight (75%) patients demonstrated asymmetric enhancement of inner ear structures on delayed contrast-enhanced imaging. Delayed mean cochlea and vestibule SIRs were significantly greater than immediate SIRs (cochlea: 1.91 versus 1.21 [p = 0.02]; vestibule 1.74 versus 1.15 [p = 0.02]). A higher vestibule SIR was statistically significantly associated with poorer pure-tone average and word recognition scores (p = 0.001).
Conclusion:
Ears with VS exhibited increased enhancement on delayed 3D FLAIR imaging. These findings suggest that alterations in blood-labyrinth barrier permeability may explain progressive sensorineural hearing loss in a subset of patients with untreated VS.
More Related Videos
10:12Three Dimensional Vestibular Ocular Reflex Testing Using a Six Degrees of Freedom Motion Platform
Published on: May 23, 2013
08:57Measuring the Influence of Magnetic Vestibular Stimulation on Nystagmus, Self-Motion Perception, and Cognitive Performance in a 7T MRT
Published on: March 3, 2023
