Wilhelm Harald Flatz MD, Presenter: Nothing to Disclose

Robert Guerkov, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Birgit Betina Ertl-Wagner MD, Abstract Co-Author: Scientific Advisory Board, Koninklijke Philips Electronics NV Consultant, Bracco Group Travel support, Siemens AG Consultant, MMI Munich Medical International GmbH Author, Springer Science+Business Media Deutschland GmbH Author, Thieme Medical Publishers, Inc

To prospectively evaluate MRI- and CT-findings of the temporal bone, including the middle and inner ear as well as adjacent soft tissue, as potantial causes for restricted diffusion of Gd-DTPA into the inner ear.

We retrospectively evaluated 32 patients with suspected Menière’s disease who underwent both multislice-CT- and locally enhanced MR imaging of the temporal bone. 24 hours prior to the MRI-scan intratympanal Gd-DTPA was administered. In addition to structural MR-imaging of the brain, CISS-, FLAIR- and IR-sequences of the temporal bone were acquired on a 3 T MR scanner using a 32 channel head coil. Slice thickness of FLAIR- and IR-images was 0.5 mm and 0.6 mm respectively. Signal intensities of the endolymphatic spaces of the basal turn of the cochlea were evaluated using ROI-based analysis. CT images were reviewed by two blinded radiologists with regard to temporal bone pathology including sclerosis of the round and oval window membrane, middle ear findings and soft tissue assessment. Thickening/sclerosis of the round and oval windows membrane were evaluated using a 6-point scale with 1 being no sclerosis and 6 high grade sclerosis.

In 9 respectively 13 patients CT-analysis of the round window respectively oval window was not possible due to acquired slice thickness. 11 of 19 patients demonstrated sclerotic changes of the oval window (grades 2 to 6). 8 of 23 patients showed sclerotic changes of the round window (grade 2 to 6). Significant differences were observed between measured signal intensities of perilymphatic spaces of the basal turn of the cochlea and degree of oval window sclerosis (P=0.0143), but not between sclerotic changes of the round window and signal intensities of the endolymphatic spaces of the basal turn of the cochlea.

Sclerotic changes of the oval window may be responsible for a restricted diffusion of contrast medium from the middle ear into the inner ear.

Sclerotic changes of the oval window may be responsible for a restricted diffusion of a whole variety of substances from the middle ear into the inner ear, including therapeutic agents.

Flatz, W, Guerkov, R, Reiser, M, Ertl-Wagner, B, Imaging of the Inner Ear in Menière’s Disease: Round and Oval Window Pathology as Possible Influential Factors for Restricted Contrast Medium Permeability.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13026629.html