ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2022
vol. 87
 
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Head and neck radiology
abstract:
Original paper

Detailed insight into magnetic resonance assessment of Ménière’s disease – description of methodology and imaging findings in a case series

Emilia Wnuk
1
,
Magdalena Lachowska
2
,
Agnieszka Jasińska-Nowacka
2
,
Edyta Maj
1
,
Olgierd Rowiński
1
,
Kazimierz Niemczyk
2

1.
2nd Department of Clinical Radiology, Medical University of Warsaw, Poland
2.
Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland
© Pol J Radiol 2022; 87: e354-e362
Online publish date: 2022/06/30
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Introduction
The study aimed to describe the methodology and detailed interpretation of magnetic resonance imaging (MRI) in patients with Ménière’s disease (MD).

Material and methods
MRIs were performed on a 3T scanner. The three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence 4 hours after a double dose of intravenous contrast was added to the standard MRI protocol in patients with clinically diagnosed MD. MRI findings of 7 patients with unilateral MD were analysed using 2 qualitative grading systems by Barath and Bernaerts.

Results
In MRI, the following changes in the group of patients with MD were observed: lack of endolymphatic hydrops (cases #1 and #7), various grades of cochlear hydrops (cases #2 and #3), various grades of vestibular hydrops (cases #4, #5, and #6), endolymphatic hydrops herniation into the semi-circular canal (case #6), and more robust perilymphatic enhancement (case #7).

Conclusions
In patients with MD, endolymphatic hydrops can be studied on MRI using 3D-FLAIR delayed post-contrast images. The qualitative grading system may be easily used in endolymphatic hydrops assessment. Recently described new radiological signs of MD such as increased perilymphatic enhancement of the cochlea and an extra low-grade VH may increase MD diagnosis sensitivity. MRI not only supports the clinical diagnosis of MD but also may help to understand its pathophysiology.

keywords:

Ménière’s disease, endolymphatic hydrops, inner ear, magnetic resonance imaging, 3D-FLAIR




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