Clinical significance of endolymphatic imaging after intratympanic gadolinium injection

Nakashima, Tsutomu; Naganawa, Shinji; Katayama, Naomi; Teranishi, Masaaki; Nakata, Seiichi; Sugiura, Makoto; Sone, Michihiko; Kasai, Sachio; Yoshioka, Mayumi; Yamamoto, Masahide

doi:10.1080/00016480902729801

Cited by 55 publications

(59 citation statements)

References 17 publications

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“…89 Third, 24 h of waiting time is needed after the administration of GBCM before starting the MR imaging. 24 The final drawback is that only the injected ear can be evaluated. One advantage of IT-GBCM is the capability for simulation of the intralabyrinthine distribution of the intratympanically administered drug.…”

Section: Endolymphatic Hydropsmentioning

confidence: 99%

“…Numerous reports have been published using IT-GBCM. 24,29, The IT-GBCM method opens the possibility for an objective diagnosis of Ménière's disease. The relationship between EH and symptoms is under investigation.…”

Section: Endolymphatic Hydropsmentioning

confidence: 99%

“…18 High sensitivity to subtle T 1 changes in fluid FLAIR is reported to be more sensitive to subtle T 1 changes in fluid than conventional T 1 -weighted images. [21][22][23][24][25][26][27][28][29][30] A FLAIR image allows the detection of subtle subarachnoid hemorrhage in the CSF space, 9 signal increases in CSF after the inhalation of oxygen, 31 and subtle compositional changes of the labyrinthine fluid (Figs. 6 and 7), 26,27,30,[32][33][34] which can be difficult to recognize on T 1 -weighted images.…”

Section: T 2 -Selective Inversion Recoverymentioning

confidence: 99%

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The Technical and Clinical Features of 3D-FLAIR in Neuroimaging

Naganawa

2015

magn reson med sci

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In clinical MR neuroimaging, 3D fluid-attenuated inversion recovery (3D-FLAIR) with a variable-flip-angle turbo spin echo sequence is becoming popular. There are more than 100 reports regarding 3D-FLAIR in the PubMed database. In this article, the technical and clinical features of 3D-FLAIR for neuroimaging are reviewed and summarized. 3D-FLAIR allows thinner slices with multi-planar reformation capability, a higher flow sensitivity, high sensitivity to subtle T 1 changes in fluid, images without cerebrospinal fluid (CSF) inflow artifacts, and a 3D dataset compatible with computer-aided analysis. In addition, 3D-FLAIR can be obtained within a clinically reasonable scan time. It is important for radiologists to be familiar with the features of 3D-FLAIR and to provide useful information for patients.

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Section: Endolymphatic Hydropsmentioning

confidence: 99%

Section: Endolymphatic Hydropsmentioning

confidence: 99%

Section: T 2 -Selective Inversion Recoverymentioning

confidence: 99%

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The Technical and Clinical Features of 3D-FLAIR in Neuroimaging

Naganawa

2015

magn reson med sci

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“…We did not use 3D-real IR, although it is good for separately visualizing the endolymph, perilymph, and bone 19 because it is not as sensitive as 3D-FLAIR for detecting faint enhancement. 20 However, we did obtain 3D-real IR and 3D-FLAIR-CONV to evaluate endolymphatic hydrops for clinical needs, as stated. We referred to 3D-CISS images to set regions of interest (ROI) on 3D-FLAIR-VFL and TI scout images.…”

Section: Mr Imagingmentioning

confidence: 99%

Estimation of Gadolinium-induced T1-shortening with Measurement of Simple Signal Intensity Ratio between the Cochlea and Brain Parenchyma on 3D-FLAIR: Correlation with T1 Measurement by TI Scout Sequence

et al. 2010

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Purpose: T 1 -shortening of labyrinthine ‰uid on 3-dimensional ‰uid-attenuated inversion recovery (3D-FLAIR) has been reported in many inner ear disorders. Although semi-quantitative assessment by simple signal intensity ratio between cochlear ‰uid and brain tissue has been tried, its feasibility using a multi-channel phased-array head coil with an inherently inhomogenous sensitivity distribution has not been fully evaluated. We evaluated the feasibility of measuring simple signal intensity ratio by correlating rapid T 1 measurements using an inversion time (TI) scout sequence.Materials and Methods: We evaluated 10 patients with Meniere's disease and 4 patients with sudden deafness. Nine of the patients with Meniere's disease received a unilateral intratympanic injection of Gd-DTPA; the tenth patient received bilateral injections. The 4 patients with sudden deafness received a double-dose intravenous injection. Magnetic resonance (MR) images were obtained 24 hours after intratympanic injections and 4 hours after intravenous injections at 3 tesla using a 32-channel head coil. We measured the ratio (CM ratio) between the signal intensity of the perilymph in the cochlea (C) and that of the medulla oblongata (M) and correlated it with the null-point inversion time (TI null ) obtained with the TI scout sequence. The TI scout consisted of 85 images obtained with TI values between 132.5 and 3087.5 ms at increments of 37.5 ms.Results: The correlation coe‹cient between TI null and the natural logarithm of the CM ratio was -0.88 (Pº0.01). There was signiˆcant negative linear correlation.Conclusions: Measurement of the simple signal intensity ratio between the cochlea and the medulla can be used for semi-quantitative analysis of 3D-FLAIR. The results of this study may facilitate clinical research of inner-ear disease using 3D-FLAIR.

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“…For patients it would mean appropriate management could be facilitated rapidly, improving long term prognosis. The advances in imaging will further advance understanding of the pathophysiology, and may eventually help predict which patients will respond best to the medical and surgical interventions currently available [41][42][43][44][45][46][47][48].…”

Section: British Journal Of Research Issn 2394-3718mentioning

confidence: 99%

What is the Current and Potential Future Role of Imaging in the Investigation of Patients with Suspected Meniere's Disease?

Mowat¹

2017

Br J Res

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Meniere's disease (MD) represents a diagnostic challenge. It's symptoms of episodic vertigo, hearing loss, tinnitus, and a sense of aural fullness share overlap with multiple other conditions. It remains a diagnosis of exclusion, with imaging only used to rule out other pathologies, notably acoustic neuroma. Technological advance has brought increased resolution to the inner ear. In the future it is likely that MD will become a radiological diagnosis.Keywords: Hydrops; Imaging; Dizziness; Vertigo Meniere's DiseaseCurrently, the primary role of imaging in the investigation of suspected MD is to exclude other pathology. MD can present with asymmetrical hearing loss. In such circumstances it is usual to perform an MRI to exclude an acoustic neuroma or other forms of cerebellopontine angle tumour. The guidance on precisely when a patient requires an MRI to investigate asymmetrical SNHL is less clear. A comparison of eight screening protocols found that the best compromise between sensitivity and specificity was achieved by a criterion requiring either a 20 dB asymmetry at two neighbouring frequencies, or 15 dB asymmetry at two frequencies between 2 and 8 kHz [1]. Similarly, in the vertiginous patient an MRI can be used to exclude, space occupying lesions such as endolymphatic sac tumours, cholesteatoma fistulas, and brain metastasis [2].In the acute setting, the symptoms of a Meniere's attack can be mimicked by an anterior inferior cerebellar artery (AICA) stroke, which shares the symptoms of vertigo, tinnitus, deafness. The other symptoms of hemiplegia, and facial weakness offer greater distinction. However, all patients presenting with such a first episode of such symptoms should have a Computed Tomography (CT) scan to exclude a central cause [3]. The symptoms of AICA occlusion, display the lack of collateral vessels to the inner ear and its high metabolic rate, an anatomical fact which may have a bearing on the pathophysiology of MD.The future importance of imaging in the investigation of the suspected MD patient will depend on the other diagnostic modalities with which it is competing. Therefore it is necessary to comparatively discuss their diagnostic accuracy.A pure tone audiogram (PTA) is a basic step in the Meniere's diagnosis. MD classically produces a fluctuating low frequency hearing loss that becomes permanent as the disease progresses. However, it can cause many other patterns of hearing loss, which may mimic differentials such as otosclerosis, or noise induced losses [4]. Electronystagmography(ENG), is another routine investigation as MD causes a reduced vestibular response in the ear affected. However, it has limited sensitivity as recent work shows only a 50% positive rate in confirmed MD cases [5].Electrocochleography (ECoG) provides electrophysiological verification. An elevated summating potential/ nerve action potential of greater than 35% is a sign of MD. However, whilst a useful part of the diagnostic battery, specificity and sensitivity remains low particularly when performed in betwee...

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Clinical significance of endolymphatic imaging after intratympanic gadolinium injection

Cited by 55 publications

References 17 publications

The Technical and Clinical Features of 3D-FLAIR in Neuroimaging

The Technical and Clinical Features of 3D-FLAIR in Neuroimaging

Estimation of Gadolinium-induced T1-shortening with Measurement of Simple Signal Intensity Ratio between the Cochlea and Brain Parenchyma on 3D-FLAIR: Correlation with T1 Measurement by TI Scout Sequence

What is the Current and Potential Future Role of Imaging in the Investigation of Patients with Suspected Meniere's Disease?

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