Michael Eliezer1, Charlotte Hautefort2, Christian Van Nechel3, Ulla Duquesne3, Jean-Pierre Guichard4, Philippe Herman2, Romain Kania2, Emmanuel Houdart4, Arnaud Attyé5, Michel Toupet6. 1. Department of Neuroradiology and MR Unit, Lariboisière University Hospital, 75010, Paris, France. michael.eliezer@aphp.fr. 2. Department of Head and Neck Surgery, Lariboisiere University Hospital, Paris, France. 3. Clinique Des Vertiges, Brussel, Belgique. 4. Department of Neuroradiology and MR Unit, Lariboisière University Hospital, 75010, Paris, France. 5. Department of Neuroradiology and MRI, SFR RMN Neurosciences, Grenoble Alpes University Hospital, Grenoble, France. 6. Centre d'Explorations Fonctionnelles Otoneurologiques, Paris, France.
Abstract
PURPOSE: Bilateral vestibulopathy (BV) is an uncommon disorder and the etiology remained idiopathic in most cases. Delayed 3D-FLAIR sequences have provided new insights into various inner ear diseases, allowing the evaluation of the endolymphatic space and the permeability of the blood-labyrinthine barrier (BLB). The aim of this study was to assess both the morphology of the endolymphatic space and the permeability of the BLB in patients with BV as evaluated by delayed 3D-FLAIR sequences. METHODS: In this retrospective study, we performed 3D-FLAIR sequences 4 h after administering contrast media to 42 patients with BV. Two radiologists independently evaluated the morphology of the endolymphatic space (either vestibular atelectasis or endolymphatic hydrops) and the permeability of the BLB. RESULTS: Morphologic anomalies of the endolymphatic space and vestibular blood-labyrinthine barrier impairment were observed in 59.6% of patients with BV. Bilateral vestibular atelectasis (VA) was found in 21 patients (50%), involving only the utricle and all three ampullas while the saccule was always observed with no sign of collapse: idiopathic BV (n = 19), aminoglycoside administration (n = 1) and few days following abdominal surgery (n = 1). One patient had bilateral vestibular malformation. BLB impairment was observed in five patients (11.9%): paraneoplastic (n = 1), lymphoma (n = 1), autoimmune (n = 1), and vestibular "neuritis" (n = 2). Seventeen patients (40.4%) had normal MRI with no endolymphatic space anomaly or BLB impairment. CONCLUSION: Patients with BV presented with morphologic anomalies of the endolymphatic space or BLB impairment in 59.6% of patients.
PURPOSE:Bilateral vestibulopathy (BV) is an uncommon disorder and the etiology remained idiopathic in most cases. Delayed 3D-FLAIR sequences have provided new insights into various inner ear diseases, allowing the evaluation of the endolymphatic space and the permeability of the blood-labyrinthine barrier (BLB). The aim of this study was to assess both the morphology of the endolymphatic space and the permeability of the BLB in patients with BV as evaluated by delayed 3D-FLAIR sequences. METHODS: In this retrospective study, we performed 3D-FLAIR sequences 4 h after administering contrast media to 42 patients with BV. Two radiologists independently evaluated the morphology of the endolymphatic space (either vestibular atelectasis or endolymphatic hydrops) and the permeability of the BLB. RESULTS: Morphologic anomalies of the endolymphatic space and vestibular blood-labyrinthine barrier impairment were observed in 59.6% of patients with BV. Bilateral vestibular atelectasis (VA) was found in 21 patients (50%), involving only the utricle and all three ampullas while the saccule was always observed with no sign of collapse: idiopathic BV (n = 19), aminoglycoside administration (n = 1) and few days following abdominal surgery (n = 1). One patient had bilateral vestibular malformation. BLB impairment was observed in five patients (11.9%): paraneoplastic (n = 1), lymphoma (n = 1), autoimmune (n = 1), and vestibular "neuritis" (n = 2). Seventeen patients (40.4%) had normal MRI with no endolymphatic space anomaly or BLB impairment. CONCLUSION:Patients with BV presented with morphologic anomalies of the endolymphatic space or BLB impairment in 59.6% of patients.
Authors: M Elmaleh-Bergès; C Baumann; N Noël-Pétroff; A Sekkal; V Couloigner; K Devriendt; M Wilson; S Marlin; G Sebag; V Pingault Journal: AJNR Am J Neuroradiol Date: 2012-12-13 Impact factor: 3.825
Authors: M Eliezer; G Poillon; A Gillibert; J Horion; Y Cruypeninck; E Gerardin; N Magne; A Attyé Journal: Diagn Interv Imaging Date: 2018-02-15 Impact factor: 4.026
Authors: Angela Wenzel; Bryan K Ward; Michael C Schubert; Amir Kheradmand; David S Zee; Georgios Mantokoudis; John Patrick Carey Journal: Otol Neurotol Date: 2014-06 Impact factor: 2.311
Authors: M N Pakdaman; G Ishiyama; A Ishiyama; K A Peng; H J Kim; W B Pope; A R Sepahdari Journal: AJNR Am J Neuroradiol Date: 2016-06-02 Impact factor: 3.825