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Comparison between 3D-FLAIR and 3D-real IR MRI sequences with visual classification method in the imaging of
Wenting Deng1, Xijun Lin1, Yun Su2
1Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Background:
Clinically, the evidence of endolymphatic hydrops (EH) in Meniere's disease (MD) primarily relies on audiological examinations, such as glycerol tests and electrocochleography, to suggest the presence of EH indirectly. However, these techniques lack sensitivity and specificity, and they do not sufficiently assess the degree of EH. This study aims to explore the application of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and three-dimensional real inversion recovery (3D-real IR) sequence imaging of EH in MD and to assess the image quality and grading of EH.
Methods:
The study included 50 patients with definite MD. The 3D-FLAIR and 3D-real IR sequence images were performed 24 h after bilateral intratympanic injection of gadolinium. The image quality of both sequences was reviewed by two experienced radiologists. The vestibular and cochlear EH grades of both sequences were reviewed by two experienced otologists using a visual grading method. The Cohen's kappa and Pearson tests were used to analyze the data.
Results:
The reliability of image quality between the two radiologists was excellent (0.7 < kappa < 0.9). There were significant statistical differences in the image quality between the 3D-real IR and 3D-FLAIR sequences (p = 0.023 and p = 0.035, respectively). The reliability for the grading of vestibular and cochlear EH between the two otologists was excellent (0.7 < kappa < 0.9). The 3D-real IR sequence detected more severe hydrops than did the 3D-FLAIR sequence (p < 05).
Conclusion:
The image quality of the 3D-real IR sequence is better than that of the 3D-FLAIR sequence, and there are differences in the vestibular and cochlear EH grades of both sequences. The sensitivity of the 3D-real IR sequence in the cochlea is higher. The method of visual grading can be applied to both technologies when combined with 3D-real IR.
Insights
The 3D-real IR MRI sequence offers superior image quality and sensitivity for detecting endolymphatic hydrops (EH) in Meniere
Area of Science:
- Radiology
- Otolaryngology
- Medical Imaging
Background:
- Current methods for diagnosing endolymphatic hydrops (EH) in Meniere's disease (MD) rely on indirect audiological tests with limited sensitivity and specificity.
- Existing diagnostic techniques do not adequately quantify the severity of EH.
- There is a need for advanced imaging techniques to directly visualize and grade EH.
Purpose of the Study:
- To evaluate the application of 3D-FLAIR and 3D-real IR MRI sequences for imaging EH in MD patients.
- To assess and compare the image quality and grading accuracy of EH using both 3D-FLAIR and 3D-real IR sequences.
- To determine the sensitivity of each sequence in detecting EH.
Main Methods:
- Fifty patients with definite Meniere's disease underwent 3D-FLAIR and 3D-real IR MRI after gadolinium injection.
- Image quality was assessed by two radiologists, and EH grading (vestibular and cochlear) was performed by two otologists using visual grading.
- Statistical analysis included Cohen's kappa for reliability and Pearson tests for comparisons.
Main Results:
- Excellent inter-rater reliability was observed for both image quality assessment (radiologists) and EH grading (otologists).
- The 3D-real IR sequence demonstrated significantly better image quality compared to the 3D-FLAIR sequence.
- The 3D-real IR sequence detected more severe hydrops and showed higher sensitivity in the cochlea compared to 3D-FLAIR.
Conclusions:
- The 3D-real IR sequence provides superior image quality and is more sensitive for detecting cochlear EH in Meniere's disease.
- Visual grading is a reliable method for assessing EH using both MRI sequences, particularly when combined with 3D-real IR.
- 3D-real IR MRI represents a promising advancement for the diagnosis and assessment of EH in Meniere's disease.
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