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

  • Head and Neck
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Abstract

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.

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Abbreviations

AAO-HNS:

American Academy of Otolaryngology–Head and Neck Surgery

CH:

Cochlear hydrops

EH:

Endolymphatic hydrops

FLAIR:

Fluid attenuated inversion recovery

MD:

Meniere’s disease

SNHL:

Sensorineural hearing loss

SURI:

Saccule to utricle ratio inversion

VH:

Vestibular hydrops

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Acknowledgments

The scientific guarantor of this publication is Arnaud Attye. The authors of this manuscript declare relationships with the following companies: This study has received funding by Guerbet SA® for MRI in healthy subjects and by the University Hospital of Grenoble for MRI in patients with Meniere’s disease.

One of the authors has significant statistical expertise (Dr Naïla Boudiaf, PhD, from the University of Grenoble). This was a single-centre, parallel-group imaging study that was registered with the ClinicalTrials.gov registry (38RC14.428 for healthy subjects/38RC15.173 for patients). It was conducted in accordance with the Declaration of Helsinki and international standards of Good Clinical Practice. The study was approved by our institutional review board (IRB 6705/15-CHUG-02). Written informed consent was obtained from all subjects in this study. This cohort has not been previously reported.

Methodology: prospective, case-control study, performed at one institution.

The authors acknowledge the valuable assistance of Hélène Fournié and Patrice Jousse for their work editing the MRI pictures and drawings. We also thank Dr Alison Foote (Grenoble Alps University Hospital) for critically editing the manuscript.

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Authors and Affiliations

  1. Department of Neuroradiology and MRI, CS 10217-Grenoble Alpes University Hospital – SFR RMN Neurosciences, F-38043, Grenoble Cedex 9, France

    Arnaud Attyé, Naïla Boudiaf & Alexandre Krainik

  2. Univ. Grenoble Alpes, IRMaGe, F-38000, Grenoble, France

    Arnaud Attyé & Alexandre Krainik

  3. Department of Radiology, Rouen University Hospital, Rouen, France

    Michael Eliezer

  4. IRMaGe, Inserm US 17, CNRS UMS 3552, Grenoble, France

    Irène Tropres

  5. Philips Healthcare, Paris, France

    David Chechin

  6. Department of Otology, Grenoble Alpes University Hospital, Grenoble, France

    Sébastien Schmerber & Georges Dumas

Authors
  1. Arnaud Attyé
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  2. Michael Eliezer
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  3. Naïla Boudiaf
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  4. Irène Tropres
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  5. David Chechin
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  6. Sébastien Schmerber
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  7. Georges Dumas
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  8. Alexandre Krainik
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Corresponding author

Correspondence to Arnaud Attyé.

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Attyé, A., Eliezer, M., Boudiaf, N. et al. MRI of endolymphatic hydrops in patients with Meniere’s disease: a case-controlled study with a simplified classification based on saccular morphology. Eur Radiol 27, 3138–3146 (2017). https://doi.org/10.1007/s00330-016-4701-z

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  • DOI: https://doi.org/10.1007/s00330-016-4701-z

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