Marco Colasurdo MD, Abstract Co-Author: Nothing to Disclose

Simone Salice MD, Presenter: Nothing to Disclose

Antonella Centonze, Abstract Co-Author: Nothing to Disclose

Giampiero Neri, Abstract Co-Author: Nothing to Disclose

Armando Tartaro MD, Abstract Co-Author: Nothing to Disclose

MRI findings in Meniere’s disease are not yet defined. The purpose of this study was to determine the main findings of endo-perilymphatic spaces in patients affected by Definite Meniere’s disease using Magnetic Resonance Imaging (MRI) with intratympanic administration of contrast agent.

Twelve patients with Definite Meniere’s disease underwent 3 Tesla MRI. 3D FLAIR and 3D T2 SE sequences were acquired 24 hours after intratympanic administration of 0.4-0.5 ml of gadobutrol diluted eightfold with saline. Contrast agent was injected through the tympanic membrane with a 25 G needle. Multi Planar Reconstructed (MPR) images were analyzed. According to literature, vestibular endolymphatic hydrops was graded considering the ratio of the area of the endolymphatic space to the vestibular fluid space (sum of the endolymphatic space and perilymphatic space). Patients with no hydrops had a ratio of one third or less, those with mild hydrops had between one-third and a half and those with severe hydrops had a ratio of more than 50%. Cochlear and semicircular canals endolymphatic hydrops was defined as positive when a MRI signal void was detected.

No adverse events due to contrast agent administration were observed. Three patients didn’t show perilymphatic enhancement thereby they were not considered for data analysis. Vestibular endolymphatic hydrops was observed in 100% of patients and it was severe in 7 out of 9 patients and mild in 2 out of 9. Whereas posterior semicircular canal endolymphatic hydrops was observed only in 5 out of 9 patients; lateral and superior semicircular canals endolymphatic hydrops was observed only in 4 out of 9 patients; cochlear endolymphatic hydrops was observed only in 5 out of 9 patients.

Our study confirms that endolymphatic hydrops can be detected at 3T MR images after intratympanic contrast agent administration and is the main finding in patients with Definite Meniere’s disease. Moreover, our preliminary results seem to suggest that endolymphatic hydrops may affect more often the vestibule than cochlea or semicircular canals.

3T MRI with intratympanic administration of contrast agent might open the door to objective evaluation of endolymphatic space and reveal Meniere’s disease pathophysiology improving diagnostic efficacy.

Colasurdo, M, Salice, S, Centonze, A, Neri, G, Tartaro, A, MR Imaging of Inner Ear Endo-perilynphatic Spaces at 3 Tesla after Intratympanic Contrast Agent Administration in Definite Meniere’s Disease.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13021615.html