Tae-Yoon Kim MD, Presenter: Nothing to Disclose

Dong-Woo Park MD, Abstract Co-Author: Nothing to Disclose

Young-Jun Lee MD, Abstract Co-Author: Nothing to Disclose

Choong-Ki Park MD, Abstract Co-Author: Nothing to Disclose

Ji Young Lee MD, Abstract Co-Author: Nothing to Disclose

To compare the signal intensity of the inner ear in patients with unilateral symptomatic ear disease, between 10 minutes and 4 hours delayed intravenous gadolinium enhanced three-dimensional fluid attenuated inversion recovery magnetic resonance images (3D-FLAIR MRI), between affected and unaffected sides, between patients with sudden sensorineural hearing loss (SNHL) and non-sudden SNHL patients, and between patients with viral disease and non-viral disease, based on clinical manifestation.

Total 50 patients with lateralizing otologic symptom, such as hearing loss, tinnitus, ear fullness, nystagmus, vertigo, facial nerve palsy, who underwent 3D-FLAIR MRI with 10 minutes and 4 hours delayed intravenous gadolinium enhancement, from May 2012 to October 2013, were retrospectively analyzed by 2 neuroradiologists blinded to the clinical presenstation. The signal intensity (SI) ratios of cochlear, vestibule, vestibulocochlear nerve (VCN), Meckel’s cavum and cisternal segment of trigeminal nerve to medulla oblongata were calculated and compared.

SI ratios of affected cochlea, vestibule, and VCN were higher than unaffected side in both 10 minutes and 4 hours. SI ratios of VCN in non-sudden SNHL patients were higher than sudden SNHL patients in both 10 minutes and 4hours. Among sudden SNHL patients, SI ratios of affected cochlea with 10 minutes delayed enhancement were significantly higher than unaffected side. SI ratios of VCN in viral disease group were higher than non-viral disease group, in both 10 minutes and 4 hours. No statistically linear correlation, but positive correlation between mean of 4 hours delayed SI ratios of Meckel’s cavum of trigeminal nerve and 4 hours delayed SI ratios of unaffected cochlea.  

SI ratios of inner ear in 10 minutes and 4 hours delayed intravenous gadolinium enhancement shows statistically significant increase in many diseases, especially viral origin disease. Anatomic discrimination of IE and VCN is better in 4 hours than 10 minutes. Positive correlation of SI ratios between trigeminal nerve and cochlea may represent the relationship of cranial nerve permeability and blood-labyrinth barrier disturbance, but requires further study.

SI ratios of inner ear can reveal correlation of contrast enhancement and diverse inner ear pathology. More accurate and objective SI ratio measurement is needed and requires further study

Kim, T, Park, D, Lee, Y, Park, C, Lee, J, Comparisons of Contrast-enhancement on Inner Ears among Patients with Unilateral Otologic Symptoms in Magnetic Resonance Images Taken at 10 Minutes and 4 Hours after Gadolinium Injection.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045650.html