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Musat GC, Sarafoleanu C, Preda MA, Tataru CP, Mitroi GG, Musat AAM, Radu M, Musat O. Utility and Challenges of Imaging in Peripheral Vestibular Disorder Diagnosis: A Narrative Review. Diagnostics (Basel) 2025; 15:1272. [PMID: 40428265 PMCID: PMC12110019 DOI: 10.3390/diagnostics15101272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2025] [Revised: 05/08/2025] [Accepted: 05/14/2025] [Indexed: 05/29/2025] Open
Abstract
This review focuses on the contribution of medical imaging in the diagnosis of peripheral vestibular disorders. This is a narrative review based on a focused literature search conducted using PubMed and the Cochrane Library. Imaging is not usually recommended in initial consultations for vestibular disorders because only 5-10% of MRI scans reveal findings directly related to the disease. The study is a review of the literature that highlights the utility and limitations of imaging such as computed tomography (CT) and magnetic resonance imaging (MRI). It follows the diagnostic approach from history and physical examination to laboratory tests and imaging. Some conditions like vestibular neuritis and benign paroxysmal positional vertigo (BPPV) have limited imaging utility due to the fine details required. Conversely, high-resolution CT and MRI are important for diagnosing Meniere's disease, acoustic neuroma, and superior canal dehiscence. The role of imaging varies a lot among specific conditions. Advances in imaging technology, particularly high-resolution MRI, promise enhanced diagnostic capabilities.
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Affiliation(s)
- Gabriela Cornelia Musat
- ENT Department, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (G.C.M.); (C.S.); (M.A.P.)
| | - Codrut Sarafoleanu
- ENT Department, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (G.C.M.); (C.S.); (M.A.P.)
| | - Mihai Alexandru Preda
- ENT Department, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (G.C.M.); (C.S.); (M.A.P.)
| | - Calin Petru Tataru
- Department of Ophthalmology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.P.T.); (O.M.)
| | - George G. Mitroi
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Mihnea Radu
- Department of General Surgery, Clinical Hospital Colentina, 020125 Bucharest, Romania;
| | - Ovidiu Musat
- Department of Ophthalmology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.P.T.); (O.M.)
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Cheng H, Zhang B, Jiang P, Liao M, Gao X, Xu D, Wang Y, Hu Y, Wang H, Liu T, Chai R. Biomaterial-based drug delivery systems in the treatment of inner ear disorders. J Nanobiotechnology 2025; 23:297. [PMID: 40247337 PMCID: PMC12004832 DOI: 10.1186/s12951-025-03368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Accepted: 04/01/2025] [Indexed: 04/19/2025] Open
Abstract
Inner ear disorders are among the predominant etiology of hearing loss. The blood-labyrinth barrier limits the ability of drugs to attain pharmacologically effective concentrations within the inner ear; consequently, delivering drugs systemically is insufficient for effectively treating inner ear disorders. Hence, it is imperative to create efficient, minimal or non-invasive methods for administering drugs to the inner ear. However, the development of such a system is hindered by three main factors: anatomical unavailability, the lack of sustained drug delivery, and individual variability. Advances in biomaterials technology have created new opportunities for overcoming existing barriers, offering great hope for the effective treatment of inner ear disorders. Hydrogel- and nanoparticle-based drug delivery systems can carry drugs to targeted designated anatomical locations in the inner ear for long-term, sustained release. Furthermore, a range of devices, including microneedles, micropumps, and cochlear implants, when paired with biomaterials, enhance the delivery of drugs to the inner ear, making the treatment of inner ear disorders more effective. Therefore, biomaterial-based drug delivery systems offer the possibility for extensive clinical uses and promise to restore hearing to millions of patients with inner ear disorders.
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Affiliation(s)
- Hong Cheng
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China
- Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, 226001, China
| | - Bin Zhang
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China
| | - Pei Jiang
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China
| | - Menghui Liao
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China
| | - Xin Gao
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China
| | - Dongyu Xu
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China
| | - Yusong Wang
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China
| | - Yangnan Hu
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China.
| | - Huan Wang
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.
| | - Tingting Liu
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China.
| | - Renjie Chai
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, State Key Laboratory of Digital Medical Engineering, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, School of Medicine, Advanced Institute for Life and Health, Southeast University, Nanjing, 210096, China.
- Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, 226001, China.
- Department of Neurology, Aerospace Center Hospital, School of Life Science, Beijing Institute of Technology, Beijing, 100081, China.
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
- Institute for Stem Cell and Regeneration, Chinese Academy of Science, Beijing, China.
- Southeast University Shenzhen Research Institute, Shenzhen, 518063, China.
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Kim R, Mihailovic D, Riemann C, Kilgué A, Pfeiffer CJ, Gehl HB, Scholtz LU, Todt I. MRI-Based Inner Ear Assessment and Cochlin Tomoprotein-Based Evaluation of Perilymphatic Fistula in Patients with Sudden Hearing Loss. Brain Sci 2024; 14:681. [PMID: 39061421 PMCID: PMC11275193 DOI: 10.3390/brainsci14070681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/19/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVES To study the correlation between positive cochlin tomoprotein testing (CTP), magnetic resonance (MR) imaging, and the auditory and vestibular function amongst patients with sudden hearing loss. STUDY DESIGN Prospective case series. METHODS We prospectively examined eight patients who presented with sudden hearing loss (>60 dB) with or without vertigo or tinnitus. We performed an ELISA-based CTP detection test using middle ear lavage samples. In addition to the CTP examination, a magnetic resonance imaging (MRI) examination was performed using different sequences (T1 and a T1 sequence with a contrast medium (CM), a T2 sequence, 4 h delayed intravenous gadolinium-enhanced three-dimensional fluid-attenuated inversion recovery (3D FLAIR)). RESULTS All patients with sudden hearing loss (>60 dB) presented a non-specific contrast enhancement in the cochlea and vestibulum on the affected side on delayed 3D-FLAIR MRI. Four patients had a positive CTP test, suggesting a perilymphatic fistula (PLF). However, no specific MRI signal for a PLF was observed. CONCLUSIONS Using multimodal diagnostic measures, such as CTP testing and different MRI sequences, no correlation could be found in patients with a PLF.
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Affiliation(s)
- Rayoung Kim
- Department of Otolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum Bielefeld, Teutoburgerstr. 50, 33604 Bielefeld, Germany; (C.R.); (A.K.); (C.J.P.); (L.-U.S.); (I.T.)
| | - Denis Mihailovic
- Department of Radiology, Medical Faculty OWL, Bielefeld University, Campus Klinikum Bielefeld, Teutoburgerstr. 50, 33604 Bielefeld, Germany; (D.M.)
| | - Conrad Riemann
- Department of Otolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum Bielefeld, Teutoburgerstr. 50, 33604 Bielefeld, Germany; (C.R.); (A.K.); (C.J.P.); (L.-U.S.); (I.T.)
| | - Alexander Kilgué
- Department of Otolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum Bielefeld, Teutoburgerstr. 50, 33604 Bielefeld, Germany; (C.R.); (A.K.); (C.J.P.); (L.-U.S.); (I.T.)
| | - Christoph Joachim Pfeiffer
- Department of Otolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum Bielefeld, Teutoburgerstr. 50, 33604 Bielefeld, Germany; (C.R.); (A.K.); (C.J.P.); (L.-U.S.); (I.T.)
| | - Hans-Björn Gehl
- Department of Radiology, Medical Faculty OWL, Bielefeld University, Campus Klinikum Bielefeld, Teutoburgerstr. 50, 33604 Bielefeld, Germany; (D.M.)
| | - Lars-Uwe Scholtz
- Department of Otolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum Bielefeld, Teutoburgerstr. 50, 33604 Bielefeld, Germany; (C.R.); (A.K.); (C.J.P.); (L.-U.S.); (I.T.)
| | - Ingo Todt
- Department of Otolaryngology, Head and Neck Surgery, Medical Faculty OWL, Bielefeld University, Campus Klinikum Bielefeld, Teutoburgerstr. 50, 33604 Bielefeld, Germany; (C.R.); (A.K.); (C.J.P.); (L.-U.S.); (I.T.)
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Saliba I, Bawazeer N, Belhassen S. Suspicion and Treatment of Perilymphatic Fistula: A Prospective Clinical Study. Audiol Res 2024; 14:62-76. [PMID: 38247562 PMCID: PMC10801529 DOI: 10.3390/audiolres14010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Background: Since the discovery of the perilymphatic fistula (PLF), the diagnosis and treatment remain controversial. If successfully recognized, the PLF is surgically repairable with an obliteration of the fistula site. Successful treatment has a major impact on patient's quality of life with an improvement in their audiological and vestibular symptoms. Objective: To prospectively investigate patients' clinical and audiological evolution with PLF suspicion after middle ear exploration and obliteration of the round and oval window. Study Design: Prospective comparative study. Setting: Tertiary care center. Methods: Patients were divided into two groups: Group I consisted of patients where no PLF had been identified intraoperatively at the oval and/or at the round window, and Group II consisted of patients where a fistula had been visualized. Patient assessment was a combination of past medical history, the presence of any risk factors, cochlear and vestibular symptoms, a physical examination, temporal bone imaging, audiograms, and a videonystagmogram (VNG). Results: A total of 98 patients were divided into two groups: 62 in Group I and 36 in Group II. A statistically significant difference regarding gender was observed in Group II (83.3% of males vs. 16.7% of females, p = 0.008). A total of 14 cases (4 and 10 in Groups I and II, respectively) were operated for a recurrent PLF. Fat graft material was used in the majority of their previous surgery; however, no difference was found when comparing fat to other materials. In addition, no statistically significant difference was noted between Groups I and II concerning predisposing factors, imaging, VNG, symptom evolution, or a physical exam before the surgery and at 12 months post-operative. However, both groups showed statistically significant hearing and vestibular improvement. On the other hand, the air conduction (AC) and bone conduction (BC) at each frequency were not statistically different between the two groups before surgery but showed statistically significant improvement at 12 months post-operatively, especially for the BC at the frequencies 250 (p = 0.02), 500 (p = 0.0008), and 1000 Hz (p = 0.04). Conclusions: Whenever you suspect a perilymphatic fistula, do not hesitate to explore middle ear and do window obliterations using a tragal perichondrium material. Our data showed that cochlear and vestibular symptoms improved whether a fistula had been identified or not.
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Affiliation(s)
- Issam Saliba
- Division of Otolaryngology-Head & Neck Surgery, University of Montreal, Montreal, QC H3C 3J7, Canada
- University of Montreal Hospital Centre Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada
- University of Montreal Hospital Centre (CHUM), Montreal, QC H2X 3E4, Canada
| | - Naif Bawazeer
- Division of Otolaryngology-Head & Neck Surgery, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Sarah Belhassen
- Division of Otolaryngology-Head & Neck Surgery, University of Montreal, Montreal, QC H3C 3J7, Canada
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Kemps G, Mistry J, Connor S, Obholzer R, Ainsworth C. Diagnosing perilymphatic fistula with 3D flair MRI. HEARING, BALANCE AND COMMUNICATION 2023. [DOI: 10.1080/21695717.2023.2181564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Glen Kemps
- Department of Otorhinolaryngology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jayran Mistry
- Department of Audiovestibular Medicine, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK
| | - Steve Connor
- Department of Radiology, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK
| | - Rupert Obholzer
- Department of Otorhinolaryngology, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK
| | - Carolyn Ainsworth
- Department of Audiovestibular Medicine, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK
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Osman S, Hautefort C, Attyé A, Vaussy A, Houdart E, Eliezer M. Increased signal intensity with delayed post contrast 3D-FLAIR MRI sequence using constant flip angle and long repetition time for inner ear evaluation. Diagn Interv Imaging 2021; 103:225-229. [PMID: 34690107 DOI: 10.1016/j.diii.2021.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study was to compare the degree of perilymphatic enhancement between 4 hour post-contrast constant flip angle three-dimensional fluid attenuated inversion recovery (3D-FLAIR) images obtained with short repetition time (TR) and those obtained with long TR. MATERIALS AND METHODS This single-center, prospective study included patients who underwent MRI of the inner ear with heavily T2-weighted sequence, 3D-FLAIR sequence with a "short" TR of 10,000 ms (s3D-FLAIR) and with a "long" TR of 16,000 ms (l3D-FLAIR). Signal intensity ratio (SIR) and contrast-to-noise ratio (CNR) obtained with s3D-FLAIR and l3D-FLAIR were quantitatively assessed using region of interest (ROI) method and compared. The morphology of the endolymphatic space on both sequences was also evaluated. RESULTS From March 2020 to July 2020, 20 consecutive patients were enrolled (9 women and 11 men; mean age, 52.1 ± 14.5 [SD] years; age range: 29-75 years). On l3D-FLAIR images, mean SIR (21.1 ± 8.8 [SD]; range: 7.6-46.1) was significantly greater than that on s3D-FLAIR images (15.7 ± 6.7 [SD]; range: 5.9-33.4) (P < 0.01). On l3D-FLAIR images, mean CNR (17 ± 8.5 [SD]; range: 2-40) was significantly greater than that on s3D-FLAIR images (12 ± 6.3 [SD]; range: 3.2-29.8) (P < 0.01). Kappa value for inter-rater agreement for endolymphatic hydrops, vestibular atelectasis and perilymphatic fistula were 0.93 (95% CI: 0.74-1), 1 (95% CI: 0.85-1) and 1 (95% CI: 0.85-1) respectively. CONCLUSION This study demonstrates that the sensitivity of 3D-FLAIR sequences to low concentration gadolinium in the perilymphatic space is improved by elongation of the TR, with SIR and CNR increased by +34.4% and +41.3% respectively.
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Affiliation(s)
- Samir Osman
- Department of Neuroradiology, Lariboisière University Hospital, Assistance Publique Hôpitaux de Paris, 75010 Paris, France
| | - Charlotte Hautefort
- Université de Paris, Faculté de Médecine, 75010 Paris, France; Department of Head and Neck Surgery, Lariboisière University Hospital, Assistance Publique Hôpitaux de Paris, 75010 Paris, France
| | - Arnaud Attyé
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital, SFR RMN Neurosciences, 38000 Grenoble, France
| | | | - Emmanuel Houdart
- Department of Neuroradiology, Lariboisière University Hospital, Assistance Publique Hôpitaux de Paris, 75010 Paris, France; Université de Paris, Faculté de Médecine, 75010 Paris, France
| | - Michael Eliezer
- Department of Neuroradiology, Lariboisière University Hospital, Assistance Publique Hôpitaux de Paris, 75010 Paris, France; Université de Paris, Faculté de Médecine, 75010 Paris, France.
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Lee B, Bae YJ, Choi BY, Kim YS, Han JH, Kim H, Choi BS, Kim JH. Construction of an MRI-based decision tree to differentiate autoimmune and autoinflammatory inner ear disease from chronic otitis media with sensorineural hearing loss. Sci Rep 2021; 11:19171. [PMID: 34580346 PMCID: PMC8476614 DOI: 10.1038/s41598-021-98557-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/09/2021] [Indexed: 12/05/2022] Open
Abstract
Autoimmune and autoinflammatory inner ear diseases (AIED/AID) are characterized by the symptom of sensorineural hearing loss (SNHL). To date, standardized diagnostic tools for AIED/AID are lacking, and clinically differentiating AIED/AID from chronic otitis media (COM) with SNHL is challenging. This retrospective study aimed to construct a magnetic resonance imaging (MRI)-based decision tree using classification and regression tree (CART) analysis to distinguish AIED/AID from COM. In total, 67 patients were enrolled between January 2004 and October 2019, comprising AIED/AID (n = 18), COM (n = 24), and control groups (n = 25). All patients underwent 3 T temporal bone MRI, including post-contrast T1-weighted images (postT1WI) and post-contrast FLAIR images (postFLAIR). Two radiologists evaluated the presence of otomastoid effusion and inner ear contrast-enhancement on MRI. A CART decision tree model was constructed using MRI features to differentiate AIED/AID from COM and control groups, and diagnostic performance was analyzed. High-intensity bilateral effusion (61.1%) and inner ear enhancement (postFLAIR, 93.8%; postT1WI, 61.1%) were the most common findings in the AIED/AID group. We constructed two CART decision tree models; the first used effusion amount as the first partitioning node and postT1WI-inner ear enhancement as the second node, whereas the second comprised two partitioning nodes with the degree of postFLAIR-enhancement of the inner ear. The first and second models enabled distinction of AIED/AID from COM with high specificity (100% and 94.3%, respectively). The amount of effusion and the degree of inner ear enhancement on MRI may facilitate the distinction between AIED/AID and COM with SNHL using decision tree models, thereby contributing to early diagnosis and intervention.
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Affiliation(s)
- Boeun Lee
- Department of Radiology, College of Medicine, Ewha Womans University, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - Yun Jung Bae
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea.
| | - Byung Yoon Choi
- Department of Otolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea.
| | - Young Seok Kim
- Department of Otolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
| | - Jin Hee Han
- Department of Otolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
| | - Hyojin Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Republic of Korea
| | - Byung Se Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
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State of the Art Imaging in Menière’s Disease. Tips and Tricks for Protocol and Interpretation. CURRENT RADIOLOGY REPORTS 2020. [DOI: 10.1007/s40134-020-00365-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Abstract
Purpose of Review
Menière’s disease (MD) is a burdensome and not well understood inner ear disorder that has received increasing attention of scientists over the past decade. Until 2007, a certain diagnosis of endolymphatic hydrops (EH) required post-mortem histology. Today, dedicated high-resolution magnetic resonance imaging (MRI) protocols enable detection of disease-related changes in the membranous labyrinth in vivo. In this review, we summarize the current status of MR imaging for MD.
Recent Findings
The mainstays of hydrops imaging are inversion recovery sequences using delayed acquisition after intravenous or intratympanic contrast administration. Based on these techniques, several methods have been developed to detect and classify EH. In addition, novel imaging features of MD, such as blood-labyrinth barrier impairment, have recently been observed.
Summary
Delayed contrast enhanced MRI has emerged as a reliable technique to demonstrate EH in vivo, with promising application in the diagnosis and follow-up of MD patients. Therefore, familiarity with current techniques and diagnostic imaging criteria is increasingly important.
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