Magnetic resonance imaging and Ménière’s disease—unavoidable alliance

Sousa, Rita; Raposo, Francisco; Guerreiro, Carla; Berhanu, David; Eça, Tiago; Campos, J.A.; Luis, Leonel

doi:10.1007/s00234-021-02744-5

Cited by 12 publications

(8 citation statements)

References 67 publications

(103 reference statements)

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“…Later on, image series with different inversion times were subtracted from each other with also subtraction of MRC images [ 7 – 10 ]. However, this process is time-consuming and carries the risk of misregistration [ 2 , 4 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the use of double and even triple dose of contrast was advocated in the beginning to overcome this lower concentration of contrast. However, with the introduction of optimized sequences, single-dose Gd administration is now considered sufficient [ 1 , 2 , 4 , 6 ]. The maximum level of contrast is reached between 3.5 and 4.5 h after IV administration [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Thin slice isotropic 3D TSE FLAIR is currently the most frequently applied IV post-Gd EH imaging sequence [ 1 – 6 ]. It is a robust sequence, requiring no postprocessing, with a very high diagnostic accuracy for the detection of EH and asymmetrical PE in patient with definite MD [ 2 – 6 ]. Whereas in the beginning non-isotropic sequences were used, nearly all sequences currently applied in literature are isotropic [ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Combining additional image markers with EH such as the degree of perilymphatic enhancement (PE) has recently been described as highly specific for MD [ 3 , 5 ]. The intravenous gadolinium (IV) administration has been widely adopted as the method of choice for hydrops imaging over the intratympanic (IT) method, with three-dimensional (3D) turbo spin-echo (TSE) fluid-attenuated inversion recovery (FLAIR) sequence as the sequence of choice over 3D REAL inversion recovery (IR) sequences, the former being more sensitive to T1-shortening [ 1 , 2 , 4 , 6 ]. Whereas, originally, 3D REAL IR was a single sequence developed for the IT administration of Gd—in which by adapting the inversion time endolymphatic space, perilymphatic space, and surrounding bone can be separately visualized—it has nowadays evolved for IV Gd use into a process of subtraction of imaging series with a different inversion time and/or a heavily T2-weighted MR cisternography (MRC) sequence [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Whereas, originally, 3D REAL IR was a single sequence developed for the IT administration of Gd—in which by adapting the inversion time endolymphatic space, perilymphatic space, and surrounding bone can be separately visualized—it has nowadays evolved for IV Gd use into a process of subtraction of imaging series with a different inversion time and/or a heavily T2-weighted MR cisternography (MRC) sequence [ 7 – 10 ]. 3D TSE FLAIR does not require this complex post-processing involving subtraction of imaging series like 3D REAL IR sequences, being time-consuming, and with potential misregistration [ 2 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparison between 3D SPACE FLAIR and 3D TSE FLAIR in Menière’s disease

et al. 2022

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Purpose Heavily T2-weighted 3D FLAIR (hT2w-3D-FLAIR) sequence with constant flip angle (CFA) has been reported as being more sensitive to low concentrations of gadolinium (Gd) enabling endolymphatic hydrops (EH) visualization. The purpose of this study was to compare signal-to-noise (SNR) ratio, detection rate of EH, and increased perilymphatic enhancement (PE) as well as diagnostic accuracy in diagnosing definite Menière’s disease (MD), using 3D-SPACE FLAIR versus conventional 3D-TSE FLAIR. Methods This retrospective study included 29 definite MD patients who underwent a 4-h delayed intravenous (IV) Gd-enhanced 3D-TSE FLAIR and 3D-SPACE FLAIR MRI between February 2019 and February 2020. MR images were qualitatively and quantitatively analyzed twice by 2 experienced head and neck radiologists. Qualitative assessment included grading of cochlear and vestibular EH and visual comparison of PE. Quantitative assessment of PE was performed by placing a region of interest (ROI) and ratio calculation in the basal turn of the cochlea and the brainstem. Results The intra- and inter-reader reliability for grading of EH and PE was excellent (0.7 < kappa < 0.9) for 3D-SPACE FLAIR and exceeded the values for 3D-TSE FLAIR (0.5 < kappa < 0.9) The combination of EH and visual assessment of PE has the highest diagnostic accuracy in diagnosing definite MD on 3D-SPACE FLAIR with a sensitivity of 0.91 and a specificity of 0.98 resulting in a sensitivity raise of 6% compared to 3D-TSE FLAIR. Conclusion Four-hour delayed IV Gd-enhanced 3D-SPACE FLAIR sequence has a higher sensitivity and reproducibility than 3D-TSE FLAIR for the visualization of EH and increased PE in definite MD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison between 3D SPACE FLAIR and 3D TSE FLAIR in Menière’s disease

et al. 2022

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Applications of Machine Learning in Meniere's Disease Assessment Based on Pure‐Tone Audiometry

Liu,

Guo,

Wang

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo apply machine learning models based on air conduction thresholds of pure‐tone audiometry for automatic diagnosis of Meniere's disease (MD) and prediction of endolymphatic hydrops (EH).Study DesignRetrospective study.SettingTertiary medical center.MethodsGadolinium‐enhanced magnetic resonance imaging sequences and pure‐tone audiometry data were collected. Subsequently, basic and multiple analytical features were engineered based on the air conduction thresholds of pure‐tone audiometry. Later, 5 classical machine learning models were trained to diagnose MD using the engineered features. The models demonstrating excellent performance were also selected to predict EH. The model's effectiveness in MD diagnosis was compared with experienced otolaryngologists.ResultsFirst, the winning light gradient boosting (LGB) machine learning model trained by multiple features demonstrates a remarkable performance on the diagnosis of MD, achieving an accuracy rate of 87%, sensitivity of 83%, specificity of 90%, and a robust area under the receiver operating characteristic curve of 0.95, which compares favorably with experienced clinicians. Second, the LGB model, with an accuracy of 78% on EH prediction, outperformed the other 3 machine learning models. Finally, a feature importance analysis reveals a pivotal role of the specific pure‐tone audiometry features that are essential for both MD diagnosis and EH prediction. Highlighted features include standard deviation and mean of the whole‐frequency hearing, the peak of the audiogram, and hearing at low frequencies, notably at 250 Hz.ConclusionAn efficient machine learning model based on pure‐tone audiometry features was produced to diagnose MD, which also showed the potential to predict the subtypes of EH. The innovative approach demonstrated a game‐changing strategy for MD screening and promising cost‐effective benefits for the health care enterprise.

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Endolymphatic hydrops in the unaffected ear of patients with unilateral Ménière’s disease

Guajardo

Suárez-Vega

Domínguez

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose Current studies show that frequency tuning modification is a good marker for the detection of endolymphatic hydrops (EH) employing magnetic resonance imaging (MRI) in patients with Ménière’s disease (MD). The purpose of the present study is to analyze the auditory and vestibular function with audiometric and vestibular-evoked myogenic potentials (VEMP) responses, respectively, in both the affected and unaffected ears of patients with unilateral MD using MRI as diagnostic support for the degree of EH. Methods We retrospectively reviewed the medical records of 76 consecutive patients with unilateral definite MD (age 55 (28–75); 39 women, 37 men). MRI was used through intravenous gadolinium administration, audiometry, and VEMPs. Functional tests were performed up to a week after the MRI. All were followed up one year after imaging utilizing clinical, auditory, and vestibular testing to rule out bilateral involvement. Results In the unaffected ear, the mean pure-tone average is normal even in cases with hydrops and, for a similar severity of hydrops is significantly lower than in the affected ear. Significant differences for the amplitude of the response at 0.5 kHz, at 1 kHz between the affected and unaffected ears were found to be lower in the affected ears. The relative amplitude ratio (1 Kz–0.5 kHz) was significantly lower in the affected ear and in the case of the oVEMP response depends on the degree of EH. The response in the unaffected ear was not modified by the presence or the degree of hydrops. Conclusion In the unaffected ear, hydrops is not associated with hearing deterioration. For a similar degree of hydrops, hearing loss is significantly greater in the affected ear. The endolymphatic hydrops in the vestibule induces a frequency bias in the VEMP response only in the affected ear and not in the unaffected ear. Because of these findings we consider that hydrops does not represent an active disorder in the unaffected ear.

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Magnetic resonance imaging and Ménière’s disease—unavoidable alliance

Cited by 12 publications

References 67 publications

Comparison between 3D SPACE FLAIR and 3D TSE FLAIR in Menière’s disease

Comparison between 3D SPACE FLAIR and 3D TSE FLAIR in Menière’s disease

Applications of Machine Learning in Meniere's Disease Assessment Based on Pure‐Tone Audiometry

Endolymphatic hydrops in the unaffected ear of patients with unilateral Ménière’s disease

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