Comparison of Inner Ear Contrast Enhancement among Patients with Unilateral Inner Ear Symptoms in MR Images Obtained 10 Minutes and 4 Hours after Gadolinium Injection

Kim, T.Y.; Park, Dong Woo; Lee, Y.J.; Lee, J.Y.; Lee, S.H.; Chung, Jae Ho; Lee, S.

doi:10.3174/ajnr.a4439

Cited by 35 publications

(36 citation statements)

References 13 publications

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“…Visualization of the inflamed vestibular nerve has become possible because of increased imaging sensitivity due to the greater magnetic field strength of scanners, as well as developments in image sequence techniques such as 3D‐FLAIR . In addition, the application of high‐dose IV Gd has increased MR enhancement . These MR techniques have also enabled better visualization of inner ear structures .…”

Section: Discussionmentioning

confidence: 99%

“…Pathological processes in VN may induce hyperemia of the affected nerve and loosening of the BLB, followed by diffusion of Gd into the fluid space of the inner ear. Presumably, simple diffusion of Gd requires time; previous reports have suggested that the enhancement of inner ear structures is most intense 4 hours after IV Gd injection …”

Section: Discussionmentioning

confidence: 99%

“…More recently, Kim et al compared the inner ear contrast enhancement in MR images obtained 10 minutes and 4 hours after IV Gd injection in patients with unilateral inner ear symptoms including sudden deafness (30 cases), vestibular schwannoma (3), Meniere's diseases (6), cholesteatoma (1), Ramsay Hunt syndrome (3), Bell's palsy (5), and VN (2). They concluded that the 4‐hour delayed images were better than 10‐minute delayed images for anatomic discrimination in conditions dominated by neural inflammation …”

Section: Introductionmentioning

confidence: 99%

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Clinical value of 4‐hour delayed gadolinium‐Enhanced 3D FLAIR MR Images in Acute Vestibular Neuritis

Byun¹,

Chung²,

Lee³

et al. 2018

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical value of 4‐hour delayed gadolinium‐Enhanced 3D FLAIR MR Images in Acute Vestibular Neuritis

Byun¹,

Chung²,

Lee³

et al. 2018

The Laryngoscope

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“…The degree of perilymphatic enhancement in 3-Tesla MRI also depend on the interval between the intravenous contrast administration and imaging. Research showed that a 4-hour delay results in greater contrast enhancement within the perilymph 28,29 . Jerin et al reported a case of a patient with VS and endolymphatic hydrops, in which ELH was revealed with the use of an inner ear LEIM MRI with an axial 3D Real-IR sequence; the authors recommended performing locally contrast-enhanced inner ear MRI in those cases in which an ELH is suspected 14 .…”

Section: Discussionmentioning

confidence: 99%

Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual Association

Ralli

Greco

Altissimi

et al. 2017

The International Tinnitus Journal

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Vestibular schwannoma and endolymphatic hydrops are two conditions that may present with similar audio-vestibular symptoms. The association of the two in the same patient represents an unusual finding that may lead clinicians to errors and delays in diagnosis and clinical management of affected subjects. We discuss the case of a patient with an intrameatal vestibular schwannoma reporting symptoms suggestive for ipsilateral endolymphatic hydrops. The patient presented with fluctuating hearing loss, tinnitus, and acute rotatory vertigo episodes, and underwent a full audiological evaluation and imaging of the brain with contrast-enhanced Magnetic Resonance Imaging. Clinical audio-vestibular and radiological examination confirmed the presence of coexisting vestibular schwannoma and endolymphatic hydrops. Hydrops was treated pharmacologically; vestibular schwannoma was monitored over time with a wait and scan protocol through conventional MRI. The association of vestibular schwannoma and endolymphatic hydrops is rare, but represents a possible finding in clinical practice. It is therefore recommended investigating the presence of inner ear disorders in patients with vestibular schwannoma and, similarly, to exclude the presence of this condition in patients with symptoms typical of inner ear disorders.

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“…To distinguish endolymph and perilymph by SSNHL Tagaya et al introduced 4‐hour delayed images of 3T FLAIR MRI with double doses (0.2 mmol/kg) of IV Gd. A recent investigation concluded that 4‐hour delayed images were more useful than 10‐minute delayed images for anatomic discrimination in unilateral inner ear diseases that cause neural inflammation …”

Section: Introductionmentioning

confidence: 99%

The clinical value of 4‐hour delayed‐enhanced 3D‐FLAIR MR images in sudden hearing loss

Byun

Chung

Lee

et al. 2019

Clinical Otolaryngology

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Objective The aim of this study was to investigate the clinical significance of 4‐hour delayed‐enhanced 3.0 Tesla (3T) 3D‐fluid‐attenuated inversion recovery (FLAIR) MR imaging in sudden sensorineural hearing loss (SSNHL). Study design Case series with comparisons. Setting Tertiary referral centre. Participants Eighty‐seven idiopathic SSNHL patients were enrolled between January 2015 and December 2016 and received high dose steroid therapy and intratympanic steroid injections as salvage treatment. Intervention Pre‐contrast, 10‐minute and 4‐hour delayed‐enhanced 3D‐FLAIR MR images were obtained using double‐dose IV gadolinium. Main outcome measures The results of treatment were evaluated according to Siegel's criteria 3 months after the start of treatment. Where possible lesion‐side laterality of the inner ear was identified based on the MR images, the associations between MR findings and other clinical parameters were analysed, and the relationships between hearing recovery and MR image findings were assessed. Results Lesion‐side laterality was identified on MRI in 52 (59.7%), 18 (20.1%) and 8 (9.2%) patients, based on 4‐hour delayed, 10‐minute delayed, and pre‐contrast images, respectively. The hearing recovery rate was significantly lower in the patients with lesion‐side laterality on 4‐hour delayed images (P < 0.001). In a multivariate analysis, lesion‐side laterality on 4‐hour delayed images was associated with poor prognosis (OR = 5.6) after adjusting other prognostic factors including initial hearing level, lesion‐side laterality on 10‐min delayed images and presence of vertigo. In addition, as the extent of enhancement in the inner ear increased the probability of hearing recover decreased (P = 0.001). Conclusions Contrast enhancement of inner ear structures can be seen on 4‐hour delayed‐enhanced 3T 3D‐FLAIR MR images in idiopathic SSNHL. Asymmetric lesion‐side enhancement of the inner ear may be associated with a poor prognosis.

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Comparison of Inner Ear Contrast Enhancement among Patients with Unilateral Inner Ear Symptoms in MR Images Obtained 10 Minutes and 4 Hours after Gadolinium Injection

Cited by 35 publications

References 13 publications

Clinical value of 4‐hour delayed gadolinium‐Enhanced 3D FLAIR MR Images in Acute Vestibular Neuritis

Clinical value of 4‐hour delayed gadolinium‐Enhanced 3D FLAIR MR Images in Acute Vestibular Neuritis

Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual Association

The clinical value of 4‐hour delayed‐enhanced 3D‐FLAIR MR images in sudden hearing loss

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