scholarly journals Signal and morphological changes in the endolymph of patients with vestibular schwannoma on non-contrast 3D FLAIR at 3 Tesla

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iichiro Osawa ◽  
Eito Kozawa ◽  
Sayuri Tanaka ◽  
Akane Kaizu ◽  
Kaiji Inoue ◽  
...  
Keyword(s):  
Inner Ear ◽  
Vestibular Schwannoma ◽  
Signal Intensity ◽  
Endolymphatic Hydrops ◽  
Morphological Changes ◽  
Affected Side ◽  
Significant Difference ◽  
Signal Changes ◽  
The Relationship ◽  
3D Flair

Abstract Background Non-contrast FLAIR revealed increased signal within the inner ear in patients with vestibular schwannoma, which is generally assumed to occur in the perilymph; however, the majority of previous studies did not differentiate between the endolymph and perilymph. Therefore, endolymph signal changes have not yet been investigated in detail. The purpose of the present study was three-fold: (1) to assess perilymph signal changes in patients with vestibular schwannoma on heavily T2-weighted (T2W) 3D FLAIR, also termed positive perilymphatic images (PPI), (2) to evaluate signal and morphological changes in the endolymph on PPI, and (3) to establish whether vertigo correlates with the signal intensity ratios (SIR) of the vestibular perilymph or vestibular endolymphatic hydrops. Methods Forty-two patients with unilateral vestibular schwannoma were retrospectively recruited. We semi-quantitatively and qualitatively evaluated the perilymph signal intensity on the affected and unaffected sides. We also quantitatively examined the signal intensity of the vestibular perilymph and assessed the relationship between vertigo and the SIR of the vestibular perilymph on the affected side. We semi-quantitatively or qualitatively evaluated the endolymph, and investigated whether vestibular hydrops correlated with vertigo. Results The perilymph on the affected side showed abnormal signal more frequently (signal intensity grade: overall mean 1.45 vs. 0.02; comparison of signal intensity: overall mean 36 vs. 0 cases) and in more parts (the entire inner ear vs. the basal turn of the cochlea and vestibule) than that on the unaffected side. No significant difference was observed in the SIR of the vestibular perilymph with and without vertigo (5.54 vs. 5.51, p = 0.18). The endolymph of the vestibule and semicircular canals showed the following characteristic features: no visualization (n = 4), signal change (n = 1), or vestibular hydrops (n = 10). A correlation was not observed between vestibular hydrops and vertigo (p = 1.000). Conclusions PPI may provide useful information on signal and morphological changes in the endolymph of patients with vestibular schwannoma. Further research is warranted to clarify the relationship between vertigo and the MR features of the inner ear.

Increased signal intensity of the cochlea on pre- and post-contrast enhanced 3D-FLAIR in patients with vestibular schwannoma

2009 ◽  
Vol 51 (12) ◽  
pp. 855-863 ◽  
Author(s):  
Masahiro Yamazaki ◽  
Shinji Naganawa ◽  
Hisashi Kawai ◽  
Takashi Nihashi ◽  
Hiroshi Fukatsu ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
Signal Intensity ◽  
Post Contrast ◽  
Contrast Enhanced ◽  
3D Flair

scholarly journals Validation of inner ear MRI in patients with Ménière’s disease by comparing endolymphatic hydrops from histopathologic specimens

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Young Sang Cho ◽  
Jong Sei Kim ◽  
Min Bum Kim ◽  
Sung Min Koh ◽  
Chang Hee Lee ◽  
...  
Keyword(s):  
Inner Ear ◽  
Temporal Bone ◽  
Semicircular Canal ◽  
Endolymphatic Hydrops ◽  
Semicircular Canals ◽  
Meniere’S Disease ◽  
Ménière’S Disease ◽  
Affected Side ◽  
Mri Scans ◽  
Temporal Bones

AbstractIntravenous gadolinium-enhanced inner-ear magnetic resonance imaging (IV-Gd inner-ear MRI) has been used to visualize endolymphatic hydrops (EH) in clinical diagnosis of Ménière’s disease (MD). However, lack of histological validation has led to several concerns regarding how best to interpret the resulting images. Here, we compared hydropic changes in temporal bone specimens with the results of IV-Gd inner-ear MRI in patients with MD. Histopathologic images of temporal bones from 37 patients with MD and 10 healthy controls were collected from the National Temporal Bone Bank of the Massachusetts Eye and Ear Infirmary in the United States. The EH ratios in the vestibule and cochlea were calculated from temporal bones using the methods used for IV-Gd inner-ear MRI, and the degree to which the saccular and utricular hydrops contributed to vestibular hydrops was measured. The presence of hydropic change in each semicircular canal was assessed using temporal bone images and compared with IV-Gd inner-ear MRI scans of 74 patients with MD. Based on human temporal bone imagery, the EH ratios in the cochlea and the vestibule on the affected side were 0.314 and 0.757, respectively. In the healthy control group, the ratio was 0.064 for the cochlea and 0.289 for the vestibule; these values were significantly different from those for the affected side of MD patients. The values for the affected ear were similar to the ratios from the IV-Gd inner-ear MRI scans in MD patients. In the vestibule, saccular hydrops were more common than utricular hydrops. The average EH ratios in the saccule and utricle were 0.513 and 0.242, respectively. No significant hydropic change from each of three semicircular canals was evident in temporal bone histopathology. However, herniation of otolithic organs (saccule or utricle) into the lateral semicircular canal was found in 44.4% of the patients, with saccular herniation (24.8%) more common than utricular herniation (16.7%). Although IV-Gd inner-ear MRI might not reflect fully the results of actual histopathology due to the limited resolution of MRI and image-processing techniques, the measured EH ratios from temporal bone specimens and IV-Gd inner-ear MRI scans were similar. Hydropic change in the three semicircular canals was not significant at either the ampullated or nonampullated end. Canal invasion of vestibular hydrops seen on MRI also appeared in temporal bone histopathology, and saccular invasion was dominant.

Mechanism of Immune Complex—Mediated Inner Ear Diseases

1992 ◽  
Vol 101 (10_suppl) ◽  
pp. 72-77 ◽  
Author(s):  
Tamotsu Harada ◽  
Mitsuhito Sano ◽  
Satoshi Ogino ◽  
Masafumi Sakagami ◽  
Toru Matsunaga
Keyword(s):  
Inner Ear ◽  
Endolymphatic Hydrops ◽  
Stria Vascularis ◽  
Capillary Endothelium ◽  
Tracer Method ◽  
Ear Diseases ◽  
Inner Ear Disease ◽  
Foot Pad ◽  
The Relationship ◽  
Ig G

Tissues of the stria vascularis of normal rabbits were collected as cochlear antigen and injected into the foot pad of guinea pigs. The mechanism of development of endolymphatic hydrops was studied by the tracer method. Damage to the capillary endothelium and an increase in vascular permeability were found in the stria vascularis. Therefore, we studied patients with a raised level of immunoglobulin (Ig) G—class circulating immune complexes (CICs). Hearing loss was found in 3 of 22 patients with significantly elevated IgG CIC levels (13.6%). The relationship between inner ear disease and the presence of CIC was considered to be very significant. The possible mechanism of CIC-mediated inner ear diseases is discussed.

scholarly journals 3D Real IR MR Findings in Acoustic Neuromas: Altered Perilymph Metabolism

2021 ◽  
pp. 014556132110471
Author(s):  
Suming Shi ◽  
Ping Guo ◽  
Wenquan Li ◽  
Wuqing Wang
Keyword(s):  
Inner Ear ◽  
Acoustic Neuroma ◽  
Intravenous Administration ◽  
Semicircular Canal ◽  
Signal Intensity ◽  
Cerebellopontine Angle ◽  
Endolymphatic Hydrops ◽  
Internal Auditory Canal ◽  
Control Side ◽  
Acoustic Neuromas

Objectives This study aimed to investigate the perilymph metabolism by analyzing the 3D real IR MR findings in acoustic neuroma (AN) after intravenous administration of gadolinium (Gd). Methods Eleven patients (6 men and 5 women) diagnosed with AN were included, and 3D real IR MRI was performed 4 hours after intravenous Gd injection. The signal intensity and details of inner ear, tumor, and internal auditory canal (IAC) by MRI were analyzed. Results Four patients had tumors confined to the IAC, and 5 had tumors that extended to the cerebellopontine angle cistern. The signal intensity of the cochlea, vestibule, and IAC fundus was conspicuously enhanced in 3D real IR images than the control side. One patient had a tumor in the cochlea, in which the signal intensity of the semicircular canal and vestibule was increased. One patient had an intravestibular tumor in which the signal intensity of the semicircular canal was increased and the cochlea had endolymphatic hydrops in the affected ear. Conclusions The synchronously increased signal intensity in the inner ear and IAC may indicate that IAC may serve as a channel for removal of the perilymph in the inner ear; the blockage by the tumor may have changed the hydrodynamics of the perilymph to cause a longer retention of Gd in the inner ear.

Inner Ear Enhancement With Delayed 3D-FLAIR MRI Imaging in Vestibular Schwannoma

2020 ◽  
Vol 41 (9) ◽  
pp. 1274-1279
Author(s):  
Andrew J. Bowen ◽  
Matthew L. Carlson ◽  
John I. Lane
Keyword(s):  
Inner Ear ◽  
Vestibular Schwannoma ◽  
Mri Imaging ◽  
3D Flair

scholarly journals Visualization of Endolymphatic Hydrops in Patients With Unilateral Idiopathic Sudden Sensorineural Hearing Loss With Four Types According to Chinese Criterion

2021 ◽  
Vol 8 ◽  
Author(s):  
Huan Qin ◽  
Baihui He ◽  
Hui Wu ◽  
Yue Li ◽  
Jianyong Chen ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Endolymphatic Hydrops ◽  
Low Frequency ◽  
Pure Tone Audiometry ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Frequency Group ◽  
Significant Difference ◽  
3D Flair

Objective: The aim of this study is to evaluate the possible value of endolymphatic hydrops (EH) in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL) with four types according to audiometry.Methods: Seventy-two patients (40 men and 32 women; age range, 28–78 years; mean age: 50.0 ± 12.9 years) with UISSNHL were admitted retrospectively into this study. Based on the pure tone audiometry before treatment, the hearing loss of all these patients were categorized into four types: low-frequency group (LF-G), high-frequency group (HF-G), flat group (F-G), and total deafness group (TD-G). The average time from symptom onset to the first examination was 6.9 ± 4.4 days (1–20 days). 3D-FLAIR MRI was performed 24 h after intratympanic injection of gadolinium (Gd) within 1 week after the UISSNHL onset. The incidence of EH in the affected ears based on four types of hearing loss were analyzed using the Chi-square test, and the possible relationship with vertigo and prognosis were also assessed.Results: Eleven of 21 patients (52.4%) in LF-G had the highest EH-positive rate, followed by 18.2% in HF-G, 11.8% in F-G, and 17.4% in TD-G. The significant difference was found in the four groups (P = 0.018). The EH rate of LF-G was statistically significantly higher than that of F-G and TD-G (P = 0.009, P =0.014), respectively. After being valued by the volume-referencing grading system (VR scores), the EH level was represented by the sum scores of EH. In LF-G, no statistically significant difference was found in the prognosis of ISSNHL patients between with the EH group and the no EH group (P = 0.586). The symptom “vertigo” did not correlate with EH and prognosis.Conclusions: EH was observed in UISSNHL patients by 3D-FLAIR MRI. EH may be responsible for the pathology of LF-G but not related to prognosis. It might be meaningless to assess EH in other hearing loss types, which might be more related to the blood-labyrinth dysfunction.

scholarly journals The Natural History of Labyrinthine Hemorrhage in Patients With Sudden Sensorineural Hearing Loss

2019 ◽  
Vol 98 (5) ◽  
pp. E13-E20 ◽  
Author(s):  
Xi-Hang Chen ◽  
Chao-Jun Zeng ◽  
Zhe-Ming Fang ◽  
Rong Zhang ◽  
Jin-Mei Cheng ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Inner Ear ◽  
Endolymphatic Hydrops ◽  
Pure Tone Audiometry ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
High Signal ◽  
Mri Scans ◽  
3D Flair

To investigate the application of inner ear 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) in patients with sudden sensorineural hearing loss (SSNHL) accompanied by inner ear hemorrhage. A total of 1252 SSNHL patients who were admitted from January 2010 to April 2018 were included in the study. The patients’ clinical features, complete blood counts, coagulation profiles, audiometry data, and MRI scans were retrospectively reviewed. Twenty-four patients had high labyrinth signals on inner ear 3D-FLAIR MRI (24/1252, 1.9%) that were diagnosed as inner ear hemorrhage. One patient had endolymphatic hydrops on the contralesional side. In the 24 patients, pure tone audiometry curves revealed profound deafness (19/24) and flat moderate hearing loss (5/24); most patients had associated vertigo (23/24) and tinnitus (19/24). Patients with SSNHL (N = 24) were treated. Sixteen patients had invalid improvement, 3 patients were markedly improved, 4 patients had effective treatment, and only 1 patient was cured, for a therapeutic efficacy of 33.3% (8/24). Follow-up 3D-FLAIR MRI in patients showed absorbance of labyrinthine hemorrhage and disappearance of the high signal intensity in the inner ear within 2 weeks to 4 months. Inner ear 3D-FLAIR MRI indicate that most cases of inner ear hemorrhage are spontaneous and that high labyrinth signals are absorbed within 4 months. The site of labyrinth hemorrhage is irregular and independent of hearing loss. Conventional treatment is not very effective, and an appropriate therapy for SSNHL requires further investigation.

The dynamics of endolymphatic hydrops and vestibular disorders

2021 ◽  
pp. 1-3
Author(s):  
Anne Charpiot ◽  
Léa Fath ◽  
Francis Veillon ◽  
Aïna Venkatasamy ◽  
Daniel Baumgartner
Keyword(s):  
Inner Ear ◽  
Dynamic Process ◽  
Clinical Symptoms ◽  
State Of The Art ◽  
Endolymphatic Hydrops ◽  
Pressure Variation ◽  
The State ◽  
Elastic Behavior ◽  
Vestibular Disorders ◽  
The Relationship

Endolymphatic hydrops is defined as an accumulation of endolymph in the inner ear leading to a buildup of pressure and distortion of intralabyrinthine structures. The pressure variation is neither obvious nor easy to measure and remains not clearly confirmed. The distortion of endolymphatic structures has been the main described phenomenon since Hallpike, Cairns and Yamakawa in 1938. However, some clinical symptoms associated with endolymphatic hydrops are in addition to the typical triad of symptoms of Meniere’s disease. This introduction to the state of the art is an analysis of the relationship between hydrops and clinical vestibular disorders, with a focus on the dynamics of endolymphatic hydrops. The distortion of endolabyrinthine structures can be considered as a dynamic process modeled with mechanical elastic behavior.

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