Magnetic resonance volumetric measurement of endolymphatic space in patients without vertiginous or cochlear symptoms

Inui, Hiroshi; Sakamoto, T.; Ito, Taeko; Kitahara, Tadashi

doi:10.1080/00016489.2016.1204663

Cited by 21 publications

(21 citation statements)

References 19 publications

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“…In the present study, we also observed changes in EH using conventional two-dimensional evaluation (Nakashima's criteria) and could not find a relationship between vertigo suppression and EH. Then, we attempted volumetric measurement of the ELS as reported by our group previously (19). In the present study, 80.0% of patients experienced relief from vertigo after ELSD (vertigo–).…”

Section: Discussionmentioning

confidence: 99%

“…We previously reported the volume of ELS and ELS ratio of controls that had never experienced vertigo/dizziness and never suffered ear disease; the volume of ELS in controls was 10.3 ± 6.9 μl (average ± standard deviation) in the cochlea and 11.5 ± 7.1 μl in the vestibule. The ELS ratio in the cochlea was 8.8 ± 5.3 and that in the vestibule was 16.2 ± 9.0 (19). Compared with the controls, the ELS ratio of vertigo– patients was still higher.…”

Section: Discussionmentioning

confidence: 99%

“…As we reported in 2016 (6, 19), source images of the inner ear fluid space (SPACE sequence image) and ELS (“PPI-PEI” image) were reconstructed on our workstation. The inner ear fluid space was manually identified from the surrounding structures by the object extraction function and cut tool of the workstation.…”

Section: Methodsmentioning

confidence: 99%

“…First, both SPACE sequence image and “PPI-PEI” image were activated on our workstation (Virtual Place) in the present study. Second, components of the inner ear were identified on SPACE sequence image by the borderlines between the inner ear and the peripheral side of the acoustic nerve, between the end of the cochlea and the vestibule, between the three ampullae of semicircular canals (SCCs) and the vestibule, and between the distal side of the common crus and the vestibule using anatomical drawings as reported previously (19). Third, counting voxels automatically on our workstation generated volume of total fluid space.…”

Section: Methodsmentioning

confidence: 99%

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Three-Dimensional Magnetic Resonance Imaging Reveals the Relationship Between the Control of Vertigo and Decreases in Endolymphatic Hydrops After Endolymphatic Sac Drainage With Steroids for Meniere's Disease

et al. 2019

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Meniere's disease is a common disease, that presents with recurrent vertigo and cochlear symptoms. The pathology of Meniere's disease was first reported to involve endolymphatic hydrops in 1938. The endolymphatic sac is thought to have a role to keep the hydrostatic pressure and endolymph homeostasis for the inner ear. As a surgery for intractable Meniere's disease, endolymphatic sac drainage with intraendolymphatic sac application of large doses of steroids is performed to control the endolymphatic hydrops and preserve or improve inner ear function. In the present study, to observe the effect of this surgery, we calculated the endolymphatic space size using 3-Tesla magnetic resonance imaging (MRI) 4 h after intravenous injection of gadolinium enhancement at two time points: just before surgery and 2 years after. To reveal the condition of the endolymphatic space, we constructed three-dimensional MR images semi-automatically and fused the three-dimensional images of the total fluid space of inner ear and the endolymphatic space. After fusing the images, we calculated the volume of the total fluid space and endolymphatic space. Two years after surgery, 16 of 20 patients (80.0%) showed relief from vertigo/dizziness and reductions in the ratio of the volume of the endolymphatic size to the total fluid space of inner ear. Endolymphatic sac drainage with intraendolymphatic sac application of large doses of steroids could control vertigo/dizziness and decrease the endolymphatic hydrops. These results indicate that endolymphatic sac drainage is a good treatment option for patients with intractable Meniere's disease. In addition, volumetric measurement of inner ear volume could be useful for confirming the effect of treatments on Meniere's disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Three-Dimensional Magnetic Resonance Imaging Reveals the Relationship Between the Control of Vertigo and Decreases in Endolymphatic Hydrops After Endolymphatic Sac Drainage With Steroids for Meniere's Disease

et al. 2019

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“…The distribution of v‐EH% widely ranged from 3.2% to 64.1%, and the median was 18.1% in this study group. The v‐EH% of patients without vertiginous or cochlear symptoms was reported to be 16.2% . This number is only a reference for healthy subjects because the study group consisted of patients with chronic rhinosinusitis, but the median value in our study group was larger than this reference value.…”

Section: Discussionmentioning

confidence: 67%

Vertical head impulse and caloric are complementary but react opposite to Meniere's disease hydrops

et al. 2018

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Objectives/Hypothesis: Meniere's disease (MD) patients can show normal head impulses despite poor caloric test results. This study aimed to investigate the discrepancy in the vestibulo-ocular reflex (VOR) in MD patients and whether endolymphatic hydrops (EH) influence the VOR.Study Design: Prospective, cross-sectional observational study. Methods: Ninety MD patients were enrolled. Neuro-otological testing, including a video head impulse test (vHIT) of all semicircular canals (SCs), and gadolinium-enhanced inner ear magnetic resonance imaging were performed. The vestibular EH volume was quantitatively evaluated by processing magnetic resonance images.Results: Abnormal vHIT results in MD patients were found most frequently in the posterior (44.4%) SCs, followed by the horizontal (13.3%) and anterior (10%) SCs. Canal paresis (CP) was assessed using the vHIT and the caloric test, and results were not significant when vHIT responses were assessed as CP only using the horizontal SC. The difference in the vestibular EH between the presence and absence of CP was not significant if assessed using the vHIT (P = .5591), but it was statistically different if assessed using the caloric test (P = .0467).Conclusions: The contradictory reaction of VOR in MD patients may result from the high specificity but low sensitivity of CP in the horizontal vHIT. EH volume in the vestibule affects the caloric response but does not affect the vHIT response.

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Endolymphatic volume in patients with meniere's disease and healthy controls: Three‐dimensional analysis with magnetic resonance imaging

Ito

Inui

Miyasaka

et al. 2019

Laryngoscope Investig Oto

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ObjectiveRecently, 3‐Tesla magnetic resonance imaging (MRI) with intravenous gadolinium injection has been used to reveal endolymphatic hydrops (EH). In the present study, we aimed to evaluate EH in patients with Meniere's disease (MD) objectively and quantitatively, and compared the endolymphatic space (ELS) in individuals with MD and healthy controls, to gain understanding of the characteristics of MD.MethodsEighty‐two patients with unilateral MD (uMD), 16 patients with bilateral MD (bMD), and 47 healthy volunteers were enrolled. All participants underwent 3‐T MRI at 4 hours after intravenous gadolinium injection. The volumes of the total fluid space (TFS) and ELS were measured semiautomatically using our workstation, and the percentage of ELS to TFS (ELS percentage) was calculated.ResultsThe ELS percentage was 13.9 in the ears of controls, 18.2 in the contralateral ear of individuals with uMD, 26.1 in the affected ears of these individuals, and 23.0 in both ears of individuals with bMD. The ELS percentages in the affected ear of uMD and the ears of bMD individuals were significantly higher than that in the ears of control individuals (P < .01, one‐way analysis of variance (ANOVA), Tukey's test).ConclusionThe ELS is significantly larger in the affected ears of uMD and in both ears of bMD individuals. Accurate diagnosis of MD can be facilitated by using 3‐T MRI 4 hours after intravenous gadolinium injection and performing volumetric measurements of the ELS.Level of Evidence2b

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Magnetic resonance volumetric measurement of endolymphatic space in patients without vertiginous or cochlear symptoms

Cited by 21 publications

References 19 publications

Three-Dimensional Magnetic Resonance Imaging Reveals the Relationship Between the Control of Vertigo and Decreases in Endolymphatic Hydrops After Endolymphatic Sac Drainage With Steroids for Meniere's Disease

Three-Dimensional Magnetic Resonance Imaging Reveals the Relationship Between the Control of Vertigo and Decreases in Endolymphatic Hydrops After Endolymphatic Sac Drainage With Steroids for Meniere's Disease

Vertical head impulse and caloric are complementary but react opposite to Meniere's disease hydrops

Endolymphatic volume in patients with meniere's disease and healthy controls: Three‐dimensional analysis with magnetic resonance imaging

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