MRI of endolymphatic hydrops in patients with Meniere’s disease: a case-controlled study with a simplified classification based on saccular morphology

• Published in: European radiology Vol. 27; no. 8; pp. 3138 - 3146
• Main Authors: Attyé, Arnaud, Eliezer, Michael, Boudiaf, Naïla, Tropres, Irène, Chechin, David, Schmerber, Sébastien, Dumas, Georges, Krainik, Alexandre
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2017; Springer Nature B.V
• Subjects: Adult; Case-Control Studies; Classification; Contrast Media - administration & dosage; Diagnostic Radiology; Disease control; Ear, Inner - diagnostic imaging; Endolymphatic Hydrops - classification; Endolymphatic Hydrops - diagnostic imaging; Endolymphatic Hydrops - pathology; Evaluation; Female; Fistulae; Head and Neck; Humans; Imaging; Imaging, Three-Dimensional; Inner ear; Internal Medicine; Interventional Radiology; Intravenous administration; Inversion; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Meniere disease; Meniere Disease - complications; Meniere Disease - diagnosis; Meniere's disease; Middle Aged; Morphology; Neuroradiology; Patients; Quantitative analysis; Radiology; Saccule; Ultrasound; Utricle; Vestibular Diseases - diagnosis; Vestibular Diseases - diagnostic imaging; Healthy subjects; Magnetic resonance imaging; Meniere’s disease; Inner ear; Endolymphatic hydrops
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-016-4701-z

Objectives Endolymphatic hydrops (EH) can be studied in patients by MRI. With the semi-quantitative grading system, previous imaging studies showed discrepancies in the occurrence and grading of EH in patients with Meniere’s disease (MD). Here, we compared the inversion of the saccule to utricle area ratio (SURI) with the semi-quantitative method of grading conventionally used to diagnose MD. Methods Imaging was carried out on a 3-T MRI scanner. We performed 3D-FLAIR sequences 4 h after a single intravenous dose of contrast agent. Two radiologists independently studied the morphology of the inner ear structures in the healthy subjects and MD patients. Each subject was then graded on the basis of the EH semi-quantitative analysis and on saccular morphology using axial and sagittal reference slices in the vestibule plane. Results Thirty healthy subjects and 30 MD patients had MRI scans. Using the semi-quantitative method, we found no significant difference in the number of subjects with EH between the two groups. SURI was found in 15 out of 30 MD patients and in none of the 30 healthy subjects. In three MD patients the saccule was not visible. Conclusion SURI is currently the most specific criterion for imaging diagnosis of MD. Key points • Half of MD patients presented with inversion of the saccule to utricle ratio. • Saccular analysis is crucial when assessing patients with Meniere’s disease. • In some patients, the saccule is not visible, suggestive of intra-labyrinthine fistulae.