Arnaud Attyé1,2, Michael Eliezer3, Naïla Boudiaf4, Irène Tropres5, David Chechin6, Sébastien Schmerber7, Georges Dumas7, Alexandre Krainik4,8. 1. Department of Neuroradiology and MRI, CS 10217-Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble Cedex 9, France. aattye@chu-grenoble.fr. 2. Univ. Grenoble Alpes, IRMaGe, F-38000, Grenoble, France. aattye@chu-grenoble.fr. 3. Department of Radiology, Rouen University Hospital, Rouen, France. 4. Department of Neuroradiology and MRI, CS 10217-Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble Cedex 9, France. 5. IRMaGe, Inserm US 17, CNRS UMS 3552, Grenoble, France. 6. Philips Healthcare, Paris, France. 7. Department of Otology, Grenoble Alpes University Hospital, Grenoble, France. 8. Univ. Grenoble Alpes, IRMaGe, F-38000, Grenoble, France.
Abstract
OBJECTIVES: Endolymphatic hydrops (EH) can be studied in patients by MRI. With the semi-quantitative grading system, previous imaging studies showed discrepancies in the occurrence and grading of EH in patients with Meniere's disease (MD). Here, we compared the inversion of the saccule to utricle area ratio (SURI) with the semi-quantitative method of grading conventionally used to diagnose MD. METHODS: Imaging was carried out on a 3-T MRI scanner. We performed 3D-FLAIR sequences 4 h after a single intravenous dose of contrast agent. Two radiologists independently studied the morphology of the inner ear structures in the healthy subjects and MD patients. Each subject was then graded on the basis of the EH semi-quantitative analysis and on saccular morphology using axial and sagittal reference slices in the vestibule plane. RESULTS: Thirty healthy subjects and 30 MD patients had MRI scans. Using the semi-quantitative method, we found no significant difference in the number of subjects with EH between the two groups. SURI was found in 15 out of 30 MD patients and in none of the 30 healthy subjects. In three MD patients the saccule was not visible. CONCLUSION: SURI is currently the most specific criterion for imaging diagnosis of MD. KEY POINTS: • Half of MD patients presented with inversion of the saccule to utricle ratio. • Saccular analysis is crucial when assessing patients with Meniere's disease. • In some patients, the saccule is not visible, suggestive of intra-labyrinthine fistulae.
OBJECTIVES: Endolymphatic hydrops (EH) can be studied in patients by MRI. With the semi-quantitative grading system, previous imaging studies showed discrepancies in the occurrence and grading of EH in patients with Meniere's disease (MD). Here, we compared the inversion of the saccule to utricle area ratio (SURI) with the semi-quantitative method of grading conventionally used to diagnose MD. METHODS: Imaging was carried out on a 3-T MRI scanner. We performed 3D-FLAIR sequences 4 h after a single intravenous dose of contrast agent. Two radiologists independently studied the morphology of the inner ear structures in the healthy subjects and MD patients. Each subject was then graded on the basis of the EH semi-quantitative analysis and on saccular morphology using axial and sagittal reference slices in the vestibule plane. RESULTS: Thirty healthy subjects and 30 MD patients had MRI scans. Using the semi-quantitative method, we found no significant difference in the number of subjects with EH between the two groups. SURI was found in 15 out of 30 MD patients and in none of the 30 healthy subjects. In three MD patients the saccule was not visible. CONCLUSION: SURI is currently the most specific criterion for imaging diagnosis of MD. KEY POINTS: • Half of MD patients presented with inversion of the saccule to utricle ratio. • Saccular analysis is crucial when assessing patients with Meniere's disease. • In some patients, the saccule is not visible, suggestive of intra-labyrinthine fistulae.
Authors: J M van Steekelenburg; A van Weijnen; L M H de Pont; O D Vijlbrief; C C Bommeljé; J P Koopman; B M Verbist; H M Blom; S Hammer Journal: AJNR Am J Neuroradiol Date: 2020-02-06 Impact factor: 3.825
Authors: S Nahmani; A Vaussy; C Hautefort; J-P Guichard; A Guillonet; E Houdart; A Attyé; M Eliezer Journal: AJNR Am J Neuroradiol Date: 2020-03-19 Impact factor: 3.825