Arnaud Attyé1, Marion Barma2, Sébastien Schmerber3, Georges Dumas3, Michael Eliezer4, Alexandre Krainik5. 1. Department of neuroradiology and MRI, Grenoble university hospital, 38000 Grenoble France; University Grenoble Alpes, 38000 Grenoble, France; IRMaGe, inserm US 17, CNRS UMS 3552, 38000 Grenoble, France. Electronic address: arnaudattye@gmail.com. 2. Department of neuroradiology and MRI, Grenoble university hospital, 38000 Grenoble France. 3. University Grenoble Alpes, 38000 Grenoble, France; Department of otolaryngology, Grenoble university hospital, 38000 Grenoble, France. 4. Department of radiology, Lariboisiere university hospital, 75000 Paris, France. 5. Department of neuroradiology and MRI, Grenoble university hospital, 38000 Grenoble France; University Grenoble Alpes, 38000 Grenoble, France; IRMaGe, inserm US 17, CNRS UMS 3552, 38000 Grenoble, France.
Abstract
BACKGROUND AND PURPOSE: In patients with Meniere's disease (MD), saccular hydrops can only be studied by magnetic resonance imaging (MRI) at a late stage when the disease is already responsible for moderate to severe hearing loss. However, these patients may also present vestibular aqueduct (VA) abnormalities. MATERIALS AND METHODS: In this prospective study (38RC14.428 for healthy subjects/38RC15.173 for patients), imaging was carried out on a 3T MRI scanner. Twenty healthy subjects (13 women, median age 53.5 [52.2-66.7]) and twenty MD patients (9 women, median age 54.5 [52-66.7]) had MRI scans with 3D-FLAIR sequences without injection, then 4 hours after a single intra-venous dose of contrast agent. Two radiologists independently ranked the morphology of the VA in the healthy subjects and in MD patients, using a three-level score (completely visible, discontinuous and not visible). Each subject was then graded, based on both the VA's appearance and on saccular hydrops presence. Inter-reader agreement tests were performed. RESULTS: In controls and patients, VA modifications were symmetrical without significant difference between the symptomatic and asymptomatic ears. The presence of at least one ear with discontinuous VA showed a correlation with clinical MD (P < 0.001) with a sensitivity of 90%. Ten patients had saccular hydrops, but only in the symptomatic ears. The evaluation of VA did not differ between MRI, both within MRI series or between the two radiologists (kappa without and with contrast agent = 0.9 and 0.92 respectively). CONCLUSION: Analysis of the vestibular aqueduct by MRI detects abnormalities in both ears of patients with unilateral MD.
BACKGROUND AND PURPOSE: In patients with Meniere's disease (MD), saccular hydrops can only be studied by magnetic resonance imaging (MRI) at a late stage when the disease is already responsible for moderate to severe hearing loss. However, these patients may also present vestibular aqueduct (VA) abnormalities. MATERIALS AND METHODS: In this prospective study (38RC14.428 for healthy subjects/38RC15.173 for patients), imaging was carried out on a 3T MRI scanner. Twenty healthy subjects (13 women, median age 53.5 [52.2-66.7]) and twenty MD patients (9 women, median age 54.5 [52-66.7]) had MRI scans with 3D-FLAIR sequences without injection, then 4 hours after a single intra-venous dose of contrast agent. Two radiologists independently ranked the morphology of the VA in the healthy subjects and in MD patients, using a three-level score (completely visible, discontinuous and not visible). Each subject was then graded, based on both the VA's appearance and on saccular hydrops presence. Inter-reader agreement tests were performed. RESULTS: In controls and patients, VA modifications were symmetrical without significant difference between the symptomatic and asymptomatic ears. The presence of at least one ear with discontinuous VA showed a correlation with clinical MD (P < 0.001) with a sensitivity of 90%. Ten patients had saccular hydrops, but only in the symptomatic ears. The evaluation of VA did not differ between MRI, both within MRI series or between the two radiologists (kappa without and with contrast agent = 0.9 and 0.92 respectively). CONCLUSION: Analysis of the vestibular aqueduct by MRI detects abnormalities in both ears of patients with unilateral MD.
Authors: Marc van Hoof; Raymond van de Berg; Marly F J A van der Lubbe; Akshayaa Vaidyanathan; Marjolein de Wit; Elske L van den Burg; Alida A Postma; Tjasse D Bruintjes; Monique A L Bilderbeek-Beckers; Patrick F M Dammeijer; Stephanie Vanden Bossche; Vincent Van Rompaey; Philippe Lambin Journal: Radiol Med Date: 2021-11-25 Impact factor: 3.469