Arnaud Attyé1,2,3, Michael Eliezer4, Maud Medici5, Irène Tropres5,6, Georges Dumas7, Alexandre Krainik8,9, Sébastien Schmerber7. 1. Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, Grenoble, France. aattye@chu-grenoble.fr. 2. IRMaGe, University Grenoble Alpes, F-38000, Grenoble, France. aattye@chu-grenoble.fr. 3. Neuroradiology and MR Unit, CS 10217- Grenoble University Hospital, F-38043, Grenoble cedex 9, France. aattye@chu-grenoble.fr. 4. Department of Radiology, Rouen University Hospital, Rouen, France. 5. Unité innovation technologique, Centre d'Investigation Clinique, CHU de Grenoble, CS 10217, 38043, Grenoble cedex 9, France. 6. IRMaGe, Inserm US 17, CNRS UMS 3552, Grenoble, France. 7. Department of Otology, Grenoble Alpes University Hospital, Grenoble, France. 8. Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, Grenoble, France. 9. IRMaGe, University Grenoble Alpes, F-38000, Grenoble, France.
Abstract
OBJECTIVES: A case-controlled imaging study demonstrated that saccular hydrops was specific to Meniere's disease (MD), but only present in a subset of patients. Here, we compared patients with definite MD, vertigo and sensorineural hearing loss (SNHL) to elucidate the relationship between saccular hydrops and extent of SNHL. METHODS: In this prospective study, we performed 3D-FLAIR sequences between 4.5 and 5.5 h after contrast media injection in patients with MD (n=20), SNHL (n=20), vertigo (n=20) and 30 healthy subjects. Two radiologists independently graded saccular hydrops. ROC analysis was performed to determine the hearing loss threshold to differentiate patients with saccular hydrops. RESULTS: Saccular hydrops was found in 11 of 20 MD patients, 10 of 20 SNHL patients and in none of the vertigo patients and healthy subjects. In SNHL patients, 45 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 90 %. In MD patients, 40 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 44 %. CONCLUSIONS: Our results indicate saccular hydrops as a feature of worse than moderate SNHL rather than MD itself. KEY POINTS: • MRI helps clinicians to assess patients with isolated low-tone sensorineural hearing loss. • Saccular hydrops correlates with sensorineural hearing loss at levels above 40 dB. • Vertigo patients without sensorineural hearing loss do not have saccular hydrops. • Saccular hydrops is described in patients without clinical diagnosis of Meniere's disease.
OBJECTIVES: A case-controlled imaging study demonstrated that saccular hydrops was specific to Meniere's disease (MD), but only present in a subset of patients. Here, we compared patients with definite MD, vertigo and sensorineural hearing loss (SNHL) to elucidate the relationship between saccular hydrops and extent of SNHL. METHODS: In this prospective study, we performed 3D-FLAIR sequences between 4.5 and 5.5 h after contrast media injection in patients with MD (n=20), SNHL (n=20), vertigo (n=20) and 30 healthy subjects. Two radiologists independently graded saccular hydrops. ROC analysis was performed to determine the hearing loss threshold to differentiate patients with saccular hydrops. RESULTS: Saccular hydrops was found in 11 of 20 MD patients, 10 of 20 SNHL patients and in none of the vertigopatients and healthy subjects. In SNHL patients, 45 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 90 %. In MD patients, 40 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 44 %. CONCLUSIONS: Our results indicate saccular hydrops as a feature of worse than moderate SNHL rather than MD itself. KEY POINTS: • MRI helps clinicians to assess patients with isolated low-tone sensorineural hearing loss. • Saccular hydrops correlates with sensorineural hearing loss at levels above 40 dB. • Vertigopatients without sensorineural hearing loss do not have saccular hydrops. • Saccular hydrops is described in patients without clinical diagnosis of Meniere's disease.
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: Michael Strupp; Julia Dlugaiczyk; Birgit Bettina Ertl-Wagner; Dan Rujescu; Martin Westhofen; Marianne Dieterich Journal: Dtsch Arztebl Int Date: 2020-04-24 Impact factor: 5.594