MR Imaging of Cochlear Modiolus and Endolymphatic Hydrops in Patients With Menière's Disease

Sousa, Rita; Guerreiro, Carla; Eça, Tiago; Campos, J.A.; Luis, Leonel

doi:10.3389/fsurg.2021.667248

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…The sensitivity and specificity of EHI in terms of MD diagnosis remain controversial. Some studies have reported sensitivities of 100% (24); another have reported a range from 73.2 to 94.2% (21). Specificity is more challenging; this depends on the prevalence of hydrops in normal controls, which is about 10% (25).…”

Section: Discussionmentioning

confidence: 99%

Endolymphatic hydrops asymmetry distinguishes patients with Meniere’s disease from normal controls with high sensitivity and specificity

Noh,

Park,

Lee

et al. 2023

Front. Neurol.

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BackgroundMany endolymphatic hydrops (EH) MRI studies in the literature do not include a normal control group. Consequently, it remains unclear which outcome measure in EH MRI can most effectively distinguish between MD patients and normal controls.MethodsGadolinium-enhanced EH imaging was performed to quantitatively evaluate the extents of hydrops in MD patients and age−/sex-matched normal controls. Four hours after intravenous injection of contrast agent, MRI was performed using a 3-T MR platform fitted with a 32-channel phased-array coil receptor. MR images (10–15 slices) covering an inner ear were 3D-stacked. Analyses of all images that included the vestibule or the cochlea yielded the volumes (in μL) of the endolymphatic and perilymphatic spaces.ResultsFor the vestibule, they were significantly greater EH% in ipsilateral (52.4 ± 12.5) than in contralateral MD ears (40.4 ± 8.5, p = 0.001) and in ipsilateral MD ears than in control ears (42.4 ± 13.7, p = 0.025). For the cochlea, the values were slightly higher EH% in ipsilateral MD ears (49.7 ± 10.4, p = 0.061) but did not significantly differ from contralateral (41.3 ± 12.6) or control ears (39.6 ± 18.9, p = 0.858). In the MD group, the EH asymmetries were 12.0 ± 10.2% (vestibule) and 8.4 ± 8.6% (cochlea), significantly larger than those of controls.ConclusionCompared to conventional semiquantitative grading or quantitative EH% analysis, EH asymmetry may better distinguish MD patients from normal controls. Quantitative hydrops volumetric analysis yields clinically relevant information on inner ear function.

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Section: Discussionmentioning

confidence: 99%

Endolymphatic hydrops asymmetry distinguishes patients with Meniere’s disease from normal controls with high sensitivity and specificity

Noh,

Park,

Lee

et al. 2023

Front. Neurol.

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“…Таким образом, при БМ в эндолимфатическом пространстве происходит задержка калия. Это вызывает калиевую интоксикацию волосковых клеток и вестибулярного нейроэпителия, в результате чего развиваются тугоухость и головокружение [48,49].…”

Section: эпидемиологияunclassified

Meniere’s Disease: The Current State of the Problem

Марьенко¹,

Поддубный²

2023

Неврология И Нейрохирургия. Восточная Европа

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Болезнь Меньера (БМ) – многофакторное заболевание внутреннего уха, характеризующееся головокружением, шумом в ушах и нейросенсорной потерей слуха. Заболевание не имеет определенной этиологической причины. Развитие БМ зависит от целого ряда факторов, которые способны приводить к эндолимфатической водянке. Основным морфологическим признаком БМ является эндолимфатический гидропс – увеличение объема эндолимфы, заполняющей перепончатый лабиринт внутреннего уха, и растяжение Рейснеровой мембраны. Различают 3 основных варианта течения заболевания. Рост количества случаев БМ у лиц молодого возраста, а также отсутствие скрининга у лиц с повышенным риском (люди в возрастной категории от 20 до 50 лет со сниженным слухом на 1 или оба уха, с отягощенным семейным анамнезом по данному заболеванию, с травмами головы и/или уха, аутоиммунными заболеваниями) делает актуальной проблему разработки методов ранней диагностики и комплексного лечения БМ в Республике Беларусь. Meniere’s disease (MD) is a multifactorial disease of the inner ear characterized by dizziness, tinnitus and sensorineural hearing loss. The disease has no definite etiological cause. The development of MD depends on a number of factors that can lead to the development of endolymphatic dropsy. The main morphological feature of MD is endolymphatic hydrops: an increase in the volume of the endolymph filling the membranous labyrinth of the inner ear, and stretching of the Reissner’s membrane. There are three main variants of the disease course. The increasing number of MD cases in young people, as well as the lack of screening in high-risk populations (individuals aged 20 to 50 years with impaired hearing in one or both ears, having family history aggravated with this disease, with head and/ or ear injuries, or with autoimmune diseases) make the issue of developing methods for early diagnosis and comprehensive treatment of MD in the Republic of Belarus relevant.

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Delayed post gadolinium MRI descriptors for Meniere’s disease: a systematic review and meta-analysis

et al. 2023

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Objectives Delayed post-gadolinium magnetic resonance imaging (MRI) detects changes of endolymphatic hydrops (EH) within the inner ear in Meniere’s disease (MD). A systematic review with meta-analysis was conducted to summarise the diagnostic performance of MRI descriptors across the range of MD clinical classifications. Materials and methods Case-controlled studies documenting the diagnostic performance of MRI descriptors in distinguishing MD ears from asymptomatic ears or ears with other audio-vestibular conditions were identified (MEDLINE, EMBASE, Web of Science, Scopus databases: updated 17/2/2022). Methodological quality was evaluated with Quality Assessment of Diagnostic Accuracy Studies version 2. Results were pooled using a bivariate random-effects model for evaluation of sensitivity, specificity and diagnostic odds ratio (DOR). Meta-regression evaluated sources of heterogeneity, and subgroup analysis for individual clinical classifications was performed. Results The meta-analysis included 66 unique studies and 3073 ears with MD (mean age 40.2–67.2 years), evaluating 11 MRI descriptors. The combination of increased perilymphatic enhancement (PLE) and EH (3 studies, 122 MD ears) achieved the highest sensitivity (87% (95% CI: 79.92%)) whilst maintaining high specificity (91% (95% CI: 85.95%)). The diagnostic performance of “high grade cochlear EH” and “any EH” descriptors did not significantly differ between monosymptomatic cochlear MD and the latest reference standard for definite MD (p = 0.3; p = 0.09). Potential sources of bias were case-controlled design, unblinded observers and variable reference standard, whilst differing MRI techniques introduced heterogeneity. Conclusions The combination of increased PLE and EH optimised sensitivity and specificity for MD, whilst some MRI descriptors also performed well in diagnosing monosymptomatic cochlear MD. Key Points • A meta-analysis of delayed post-gadolinium magnetic resonance imaging (MRI) for the diagnosis of Meniere’s disease is reported for the first time and comprised 66 studies (3073 ears). • Increased enhancement of the perilymphatic space of the inner ear is shown to be a key MRI feature for the diagnosis of Meniere’s disease. • MRI diagnosis of Meniere’s disease can be usefully applied across a range of clinical classifications including patients with cochlear symptoms alone.

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MR Imaging of Cochlear Modiolus and Endolymphatic Hydrops in Patients With Menière's Disease

Cited by 4 publications

References 22 publications

Endolymphatic hydrops asymmetry distinguishes patients with Meniere’s disease from normal controls with high sensitivity and specificity

Endolymphatic hydrops asymmetry distinguishes patients with Meniere’s disease from normal controls with high sensitivity and specificity

Meniere’s Disease: The Current State of the Problem

Delayed post gadolinium MRI descriptors for Meniere’s disease: a systematic review and meta-analysis

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