Abstract
Endolymphatic hydrops, the primary pathologic alteration in Menière disease, can be visualized by using delayed intravenous contrast-enhanced 3D-FLAIR MR imaging. It is not known whether MR imaging-demonstrable changes of hydrops fluctuate with disease activity or are fixed. We describe the results of baseline and posttreatment MR imaging studies in a group of subjects with Menière disease with hydrops who were treated with acetazolamide. Seven subjects with untreated Menière disease with MR imaging evidence of hydrops had repeat MR imaging during acetazolamide treatment. Symptoms and imaging findings were assessed at each time point. Five subjects showed symptom improvement, of whom 3 had improvement or resolution of hydrops. One subject had recurrent symptoms with recurrent hydrops after discontinuing therapy. Two had unchanged hydrops despite symptom improvement. Subjects with unchanged symptoms had unchanged hydrops. Hydrops reversal may be seen with acetazolamide treatment in Menière disease. MR imaging may provide an additional biomarker of disease.
Highlights
Our goal was to evaluate baseline and posttreatment MR imaging changes of endolymphatic hydrops in a group of patients with Meniere disease (MD) treated with oral acetazolamide, with the goal of developing a noninvasive objective biomarker for disease activity
Imaging MR imaging was performed on a 3T Magnetom Skyra unit (Siemens, Erlangen, Germany) by using a 16-channel head and neck coil, 4 hours following an intravenous injection of 0.2 mmol/kg of either gadopentetate dimeglumine (Magnevist; Bayer HealthCare Pharmaceuticals, Wayne, New Jersey) or gadobutrol (Gadavist; Bayer Schering Pharma, Berlin, Germany)
No strong clinical application has been established for this technique, and existing research is mostly limited to showing a connection between a clinical diagnosis of MD and imaging evidence of hydrops
Summary
Our goal was to evaluate baseline and posttreatment MR imaging changes of endolymphatic hydrops in a group of patients with MD treated with oral acetazolamide, with the goal of developing a noninvasive objective biomarker for disease activity
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