Quantification of Endolymphatic Space Volume after Intravenous Administration of a Single Dose of Gadolinium-based Contrast Agent: 3D-real Inversion Recovery versus HYDROPS-Mi2

Ohashi, Toshio; Naganawa, Shinji; Takeuchi, Ai; Katagiri, Toshio; Kuno, Kayao

doi:10.2463/mrms.mp.2019-0013

Cited by 15 publications

(17 citation statements)

References 15 publications

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“…Accordingly, not all ELH grade results in cochlea or vestibulum correspond to each other due to the usage of different conventions [as an example grade 1 in (19,20,24)], or not at all [as an example ( 73)]. Based on either manually drawn (28,74) regions of interest (ROIs) or a convolutional neural network (CNN) segmentation (32), 2D quantification methods already offer an increased comparability and variability of information. However, the comparability of the results remains limited by the slice selection for the calculation of the ratio and the differing slices emerging from slice planning or MRI setup (sequence type, slice thickness, slice resolution).…”

Section: Within a Specific Dosage And Time Delaymentioning

confidence: 99%

“…Yet here, too, methodological variations affect reproducibility and availability of results. The critical points are the segmentation of the inner ear from the background [manually (29) (26,28,29,78) vs. open source (31)]. The less human-dependent and the more automated, the more reproducible the method in most cases.…”

Section: Within a Specific Dosage And Time Delaymentioning

confidence: 99%

“…However, to date not many iMRI ELS values have been published in absolute (26,30,92) and relative sizes (26,28,85,(93)(94)(95); those that have been published were mostly group-specific but not grade-specific, and one grade-specific but relative (26). In Table 5, 2D-and 3D-quantifications, relative, and normalized to TFS are presented.…”

Section: Normalization and Standardization Of Els Valuesmentioning

confidence: 99%

“…Data acquisition protocols have undergone a continuous optimization of MR sequences (14,15), as well as a steady minimization of procedural invasiveness (via a shift from intratympanic to intravenous application), duration and Gd dosage (16)(17)(18). A variety of cochlear and vestibular ELH quantification conventions have been suggested, including ELS semi-quantitative visual grading (19)(20)(21)(22)(23)(24)(25), manual measurement (26)(27)(28), semi-automatic (29,30), and automatic algorithmic area ratio (AR), and volumetric segmentation (31,32).…”

Section: Introductionmentioning

confidence: 99%

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Intravenous Delayed Gadolinium-Enhanced MR Imaging of the Endolymphatic Space: A Methodological Comparative Study

et al. 2021

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In-vivo non-invasive verification of endolymphatic hydrops (ELH) by means of intravenous delayed gadolinium (Gd) enhanced magnetic resonance imaging of the inner ear (iMRI) is rapidly developing into a standard clinical tool to investigate peripheral vestibulo-cochlear syndromes. In this context, methodological comparative studies providing standardization and comparability between labs seem even more important, but so far very few are available. One hundred eight participants [75 patients with Meniere's disease (MD; 55.2 ± 14.9 years) and 33 vestibular healthy controls (HC; 46.4 ± 15.6 years)] were examined. The aim was to understand (i) how variations in acquisition protocols influence endolymphatic space (ELS) MR-signals; (ii) how ELS quantification methods correlate to each other or clinical data; and finally, (iii) how ELS extent influences MR-signals. Diagnostics included neuro-otological assessment, video-oculography during caloric stimulation, head-impulse test, audiometry, and iMRI. Data analysis provided semi-quantitative (SQ) visual grading and automatic algorithmic quantitative segmentation of ELS area [2D, mm2] and volume [3D, mm3] using deep learning-based segmentation and volumetric local thresholding. Within the range of 0.1–0.2 mmol/kg Gd dosage and a 4 h ± 30 min time delay, SQ grading and 2D- or 3D-quantifications were independent of signal intensity (SI) and signal-to-noise ratio (SNR; FWE corrected, p < 0.05). The ELS quantification methods used were highly reproducible across raters or thresholds and correlated strongly (0.3–0.8). However, 3D-quantifications showed the least variability. Asymmetry indices and normalized ELH proved the most useful for predicting quantitative clinical data. ELH size influenced SI (cochlear basal turn p < 0.001), but not SNR. SI could not predict the presence of ELH. In conclusion, (1) Gd dosage of 0.1–0.2 mmol/kg after 4 h ± 30 min time delay suffices for ELS quantification. (2) A consensus is needed on a clinical SQ grading classification including a standardized level of evaluation reconstructed to anatomical fixpoints. (3) 3D-quantification methods of the ELS are best suited for correlations with clinical variables and should include both ears and ELS values reported relative or normalized to size. (4) The presence of ELH increases signal intensity in the basal cochlear turn weakly, but cannot predict the presence of ELH.

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Section: Within a Specific Dosage And Time Delaymentioning

confidence: 99%

Section: Within a Specific Dosage And Time Delaymentioning

confidence: 99%

Section: Normalization and Standardization Of Els Valuesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intravenous Delayed Gadolinium-Enhanced MR Imaging of the Endolymphatic Space: A Methodological Comparative Study

et al. 2021

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“…[2][3][4] Currently, MR imaging obtained at 4 hours after intravenous administration of a single dose of gadolinium-based contrast agent (IV-SD-GBCA) is the method frequently utilized for a detailed evaluation of EH in the clinic. [5][6][7] The hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) images and 3D-real inversion recovery (IR) images are widely used for this precise evaluation. 6,8,9 The true etiology and pathophysiology of EH remains incompletely understood.…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional Area of the Superior Petrosal Sinus is Reduced in Patients with Significant Endolymphatic Hydrops

Naganawa¹,

Ito²,

Kawai³

et al. 2022

magn reson med sci

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Purpose: To evaluate the relationship between the size of the venous structures related to the inner ear and the degree of endolymphatic hydrops (EH). Methods: Thirty-four patients with a suspicion of EH underwent whole brain MR imaging including the inner ear. Images were obtained pre- and post-administration, and at 4 and 24 hours after the intravenous administration of a gadolinium-based contrast agent (IV-GBCA). The cross-sectional areas (CSA) of the internal jugular vein (IJV), superior petrosal sinus (SPS), and inferior petrosal sinus (IPS) were measured on the magnetization prepared rapid acquisition of gradient echo (MPRAGE) images obtained immediately after the IV-GBCA. The grade of EH was determined on the hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) images obtained at 4 hours after IV-GBCA as no, mild, and significant EH according to the previously proposed grading system for the cochlea and vestibule, respectively. The ipsilateral CSA was compared between groups with each level of EH grade. P < 0.05 was considered statistically significant. Results: There were no statistically significant differences between EH grades for the CSA of the IJV or that of the IPS in either the cochlea or the vestibule. The CSA of the SPS in the groups with significant EH was significantly smaller than that in the group with no EH, for both the cochlea ( P < 0.01) and the vestibule ( P < 0.05). In an ROC analysis to predict significant EH, the cut-off CSA value in the SPS was 3.905 mm 2 for the cochlea (AUC: 0.8762, 95% confidence interval [CI]: 0.7952‒0.9572) and 3.805 mm 2 for the vestibule (AUC: 0.7727, 95% CI: 0.6539‒0.8916). Conclusion: In the ears with significant EH in the cochlea or vestibule, the CSA of the ipsilateral SPS was smaller than in the ears without EH.

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High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

Zou

Chen

et al. 2021

Eur Arch Otorhinolaryngol

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Background It is still challenging to detect endolymphatic hydrops (EH) in patients with Meniere’s disease (MD) using MRI. The aim of the present study was to optimize a sensitive technique generating strong contrast enhancement from minimum gadolinium–diethylenetriamine pentaacetic acid (Gd–DTPA) while reliably detecting EH in the inner ear, including the apex. Materials and methods All imaging was performed using a 3.0 T MR system 24 h after intratympanic injection of low-dose Gd–DTPA. Heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed with magnitude and zero-filled interpolation (hT2W–FLAIR–ZFI) was optimized and validated in phantom studies and compared with medium inversion time inversion recovery imaging with magnitude reconstruction (MIIRMR). The following parameters were used in hT2W–FLAIR–ZFI: repetition time 14,000 ms, echo time 663 ms, inversion time 2900 ms, flip angle 120°, echo train length 271, and field of view 166 × 196 mm2. Results MRI obtained using hT2W–FLAIR–MZFI yielded high-quality images with sharper and smoother borders between the endolymph and perilymph and a higher signal intensity ratio and more homogenous perilymph enhancement than those generated with MIIRMR (p < 0.01). There were predominantly grade II EHs in the cochleae and grade III EHs in the vestibule in definite MD. EH was detected in the apex of 11/16 ipsilateral ears, 3/16 contralateral ears in unilateral definite MD and 3/6 ears in bilateral MD. Conclusions The novel hT2W–FLAIR–MZFI technique is sensitive and demonstrates strong and homogenous enhancement by minimum Gd–DTPA in the inner ear, including the apex, and yields high-quality images with sharp borders between the endolymph and perilymph.

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Quantification of Endolymphatic Space Volume after Intravenous Administration of a Single Dose of Gadolinium-based Contrast Agent: 3D-real Inversion Recovery versus HYDROPS-Mi2

Cited by 15 publications

References 15 publications

Intravenous Delayed Gadolinium-Enhanced MR Imaging of the Endolymphatic Space: A Methodological Comparative Study

Intravenous Delayed Gadolinium-Enhanced MR Imaging of the Endolymphatic Space: A Methodological Comparative Study

Cross-sectional Area of the Superior Petrosal Sinus is Reduced in Patients with Significant Endolymphatic Hydrops

High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

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