Diagnostic value and clinical application of inner ear imaging after an intratympanic injection of gadolinium for Meniere's disease

Abstract

To explore the positive visualization rate of endolymph space in Meniere's disease (MD) by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) and assess its diagnostic value of MD. 3D-FLAIR MRI was performed at 24 h after an intratympanic injection of gadolinium diethylenetriamine penta-acetic acid in 51 MD patients. Then the examination results were summarized, analyzed and compared with those of vestibular evoked myogenic potential (VEMP) and glycerol tests. Gadolinium was found in perilymph inside inner ear. Furthermore the border between perilymph and endolymph was visible so that endolymphatic space was distinctly visualized on 3D-FLAIR MRI. Forty-nine (96.1%) patients demonstrated the signs of endolymphatic hydrops. Statistically significant differences existed between the results of 3D-FLAIR MRI and those of VEMP and glycerol tests (P < 0.05). No complication of tympanic membrane perforation or infection was observed. After an intratympanic injection of gadolinium, 3D-FLAIR MRI has a higher positive rate in MD patients. Though as an invasive procedure, it has fewer side effects and will become an important diagnostic tool for MD.