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Published in: European Archives of Oto-Rhino-Laryngology 5/2019

01-05-2019 | Magnetic Resonance Imaging | Otology

Post-contrast 3D-FLAIR in idiopathic sudden sensorineural hearing loss

Published in: European Archives of Oto-Rhino-Laryngology | Issue 5/2019

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Abstract

Purpose

Our study investigated correlations between clinical characteristics, particularly hearing recovery, interval time between onset and three-dimensional fluid attenuation inversion recovery magnetic resonance imaging (3D-FLAIR MRI), and the signal intensity of post-contrast 3D-FLAIR MRI in patients with idiopathic sudden sensorineural hearing loss (SSNHL).

Methods

The study enrolled 100 SSNHL patients. The signal intensities and asymmetry ratios of the inner ear structures, including the cochleae, vestibules and vestibulocochlear nerve, were evaluated and calculated. The relationships between the clinical characteristics and MRI findings were assessed.

Results

After intravenous gadolinium (Gd) injection, 3D-FLAIR revealed high signal intensities in 65 patients. The corrected asymmetry ratios of cochlea correlated closely with interval time between onset and MRI. The asymmetry ratios of the inner ear structures were significantly lower in patients with final complete to partial hearing recovery. The corrected asymmetry ratios of the inner ear structures correlated with initial/final pure tone audiometry (PTA) and hearing recovery in the affected ear. Notably, it was shown that the corrected asymmetry ratios identified a poor prognosis for hearing recovery, with a sensitivity and specificity of 67.9% and 75.0% in the cochlea, 83.3% and 75.0% in the vestibule, and 52.4% and 81.2% in the vestibulocochlear nerve, respectively.

Conclusions

Post-contrast 3D-FLAIR after intravenous Gd injection in SSNHL can be used to assess the permeability of the blood–labyrinth and blood–nerve barriers. The asymmetry ratios of the inner ear structures may identify patients with poor prognosis for hearing recovery. Signal characteristics are closely related to interval time between onset and MRI.
Literature
2.
go back to reference Biavati MJ, Gross JD, Wilson WR, Dina TS (1994) Magnetic resonance imaging evidence of a focal pontine ischemia in sudden hearing loss and seventh nerve paralysis. Am J Otol 15(2):250–253PubMed Biavati MJ, Gross JD, Wilson WR, Dina TS (1994) Magnetic resonance imaging evidence of a focal pontine ischemia in sudden hearing loss and seventh nerve paralysis. Am J Otol 15(2):250–253PubMed
4.
go back to reference Eisenman D, Arts HA (2000) Effectiveness of treatment for sudden sensorineural hearing loss. Arch Otolaryngol Head Neck Surg 126(9):1161–1164CrossRefPubMed Eisenman D, Arts HA (2000) Effectiveness of treatment for sudden sensorineural hearing loss. Arch Otolaryngol Head Neck Surg 126(9):1161–1164CrossRefPubMed
6.
go back to reference Hajnal JV, Bryant DJ, Kasuboski L, Pattany PM, De Coene B, Lewis PD, Pennock JM, Oatridge A, Young IR, Bydder GM (1992) Use of fluid attenuated inversion recovery (FLAIR) pulse sequences in MRI of the brain. J Comput Assist Tomogr 16(6):841–844CrossRefPubMed Hajnal JV, Bryant DJ, Kasuboski L, Pattany PM, De Coene B, Lewis PD, Pennock JM, Oatridge A, Young IR, Bydder GM (1992) Use of fluid attenuated inversion recovery (FLAIR) pulse sequences in MRI of the brain. J Comput Assist Tomogr 16(6):841–844CrossRefPubMed
7.
go back to reference Huang LQ, Whitworth JA, Chesterman CN (1995) Effects of cyclosporin A and dexamethasone on haemostatic and vasoactive functions of vascular endothelial cells. Blood Coagul Fibrinolysis 6(5):438–445CrossRefPubMed Huang LQ, Whitworth JA, Chesterman CN (1995) Effects of cyclosporin A and dexamethasone on haemostatic and vasoactive functions of vascular endothelial cells. Blood Coagul Fibrinolysis 6(5):438–445CrossRefPubMed
8.
go back to reference Hughes GB, Freedman MA, Haberkamp TJ, Guay ME (1996) Sudden sensorineural hearing loss. Otolaryngol Clin N Am 29(3):393–405 Hughes GB, Freedman MA, Haberkamp TJ, Guay ME (1996) Sudden sensorineural hearing loss. Otolaryngol Clin N Am 29(3):393–405
12.
go back to reference Kim TY, Park DW, Lee YJ, Lee JY, Lee SH, Chung JH, Lee S (2015) Comparison of inner ear contrast enhancement among patients with unilateral inner ear symptoms in MR images obtained 10 minutes and 4 hours after gadolinium injection. AJNR Am J Neuroradiol 36(12):2367–2372. https://doi.org/10.3174/ajnr.A4439 CrossRefPubMed Kim TY, Park DW, Lee YJ, Lee JY, Lee SH, Chung JH, Lee S (2015) Comparison of inner ear contrast enhancement among patients with unilateral inner ear symptoms in MR images obtained 10 minutes and 4 hours after gadolinium injection. AJNR Am J Neuroradiol 36(12):2367–2372. https://​doi.​org/​10.​3174/​ajnr.​A4439 CrossRefPubMed
15.
go back to reference Loughran S (2000) Management of sudden sensorineural hearing loss: a consultant survey. J Laryngol Otol 114(11):837–839CrossRefPubMed Loughran S (2000) Management of sudden sensorineural hearing loss: a consultant survey. J Laryngol Otol 114(11):837–839CrossRefPubMed
17.
go back to reference Morange PE, Aubert J, Peiretti F, Lijnen HR, Vague P, Verdier M, Negrel R, Juhan-Vague I, Alessi MC (1999) Glucocorticoids and insulin promote plasminogen activator inhibitor 1 production by human adipose tissue. Diabetes 48(4):890–895CrossRefPubMed Morange PE, Aubert J, Peiretti F, Lijnen HR, Vague P, Verdier M, Negrel R, Juhan-Vague I, Alessi MC (1999) Glucocorticoids and insulin promote plasminogen activator inhibitor 1 production by human adipose tissue. Diabetes 48(4):890–895CrossRefPubMed
23.
go back to reference Tanigawa T, Shibata R, Tanaka H, Gosho M, Katahira N, Horibe Y, Nakao Y, Ueda H (2015) Usefulness of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging to detect inner-ear abnormalities in patients with sudden sensorineural hearing loss. J Laryngol Otol 129(1):11–15. https://doi.org/10.1017/S0022215114003028 CrossRefPubMed Tanigawa T, Shibata R, Tanaka H, Gosho M, Katahira N, Horibe Y, Nakao Y, Ueda H (2015) Usefulness of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging to detect inner-ear abnormalities in patients with sudden sensorineural hearing loss. J Laryngol Otol 129(1):11–15. https://​doi.​org/​10.​1017/​S002221511400302​8 CrossRefPubMed
25.
go back to reference Whitaker S (1980) Idiopathic sudden hearing loss. Am J Otol 1(3):180–183PubMed Whitaker S (1980) Idiopathic sudden hearing loss. Am J Otol 1(3):180–183PubMed
26.
go back to reference Wilson WR, Byl FM, Laird N (1980) The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 106(12):772–776CrossRefPubMed Wilson WR, Byl FM, Laird N (1980) The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 106(12):772–776CrossRefPubMed
28.
go back to reference Zivadinov R, Ramasamy DP, Hagemeier J, Kolb C, Bergsland N, Schweser F, Dwyer MG, Weinstock-Guttman B, Hojnacki D (2018) Evaluation of leptomeningeal contrast enhancement using pre-and postcontrast subtraction 3D-FLAIR imaging in multiple sclerosis. AJNR Am J Neuroradiol 39(4):642–647. https://doi.org/10.3174/ajnr.A5541 CrossRefPubMed Zivadinov R, Ramasamy DP, Hagemeier J, Kolb C, Bergsland N, Schweser F, Dwyer MG, Weinstock-Guttman B, Hojnacki D (2018) Evaluation of leptomeningeal contrast enhancement using pre-and postcontrast subtraction 3D-FLAIR imaging in multiple sclerosis. AJNR Am J Neuroradiol 39(4):642–647. https://​doi.​org/​10.​3174/​ajnr.​A5541 CrossRefPubMed
Metadata
Title
Post-contrast 3D-FLAIR in idiopathic sudden sensorineural hearing loss
Publication date
01-05-2019
Published in
European Archives of Oto-Rhino-Laryngology / Issue 5/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05285-z

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