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Japanese Journal of Radiology
Published in: Japanese Journal of Radiology 4/2014

01-04-2014 | Review

Visualization of endolymphatic hydrops with MR imaging in patients with Ménière’s disease and related pathologies: current status of its methods and clinical significance

Authors: Shinji Naganawa, Tsutomu Nakashima

Published in: Japanese Journal of Radiology | Issue 4/2014

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Abstract

Ménière’s disease is an inner ear disorder characterized by vertigo attacks, fluctuating low-frequency hearing loss, ear fullness, and tinnitus. Endolymphatic hydrops has long been thought to be the pathological basis for Ménière’s disease. Some patients have inner ear symptoms that do not match the diagnostic guidelines for Ménière’s disease, and these are also thought to be related to endolymphatic hydrops. The diagnosis of endolymphatic hydrops is usually made based on clinical symptoms with some assistance from otological functional tests. Recently, the objective diagnosis of endolymphatic hydrops by MR imaging has become possible and many research results have been reported regarding the imaging methods, evaluation methods, the correlation between imaging results and functional otological tests and the correlation between imaging findings and clinical symptoms. In this article we summarize the development of current imaging methods, evaluation techniques and clinical reports based on a review of the literature. We also attempt to characterize the current significance and future directions of MR imaging of endolymphatic hydrops.
Literature
1.
Nakashima T, Naganawa S, Sugiura M, Teranishi M, Sone M, Hayashi H, et al. Visualization of endolymphatic hydrops in patients with Meniere’s disease. Laryngoscope. 2007;117(3):415–20.PubMedCrossRef
2.
Niyazov DM, Andrews JC, Strelioff D, Sinha S, Lufkin R. Diagnosis of endolymphatic hydrops in vivo with magnetic resonance imaging. Otol Neurotol. 2001;22(6):813–7.PubMedCrossRef
3.
Chen X, Zhang XD, Gu X, Fang ZM, Zhang R. Endolymphatic space imaging in idiopathic sudden sensorineural hearing loss with vertigo. Laryngoscope. 2012;122(10):2265–8.PubMedCrossRef
4.
Kasai S, Teranishi M, Katayama N, Sugiura M, Nakata S, Sone M, et al. Endolymphatic space imaging in patients with delayed endolymphatic hydrops. Acta Otolaryngol. 2009;129(11):1169–74.PubMedCrossRef
5.
Kato M, Sugiura M, Shimono M, Yoshida T, Otake H, Kato K, et al. Endolymphatic hydrops revealed by magnetic resonance imaging in patients with atypical Meniere’s disease. Acta Otolaryngol. 2013;133(2):123–9.PubMedCrossRef
6.
Miyagawa M, Fukuoka H, Tsukada K, Oguchi T, Takumi Y, Sugiura M, et al. Endolymphatic hydrops and therapeutic effects are visualized in ‘atypical’ Meniere’s disease. Acta Otolaryngol. 2009;129(11):1326–9.PubMedCrossRef
7.
Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere’s disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg. 1995;113(3):181–5.
8.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Visualization of endolymphatic hydrops in Meniere’s disease with single-dose intravenous gadolinium-based contrast media using heavily T(2)-weighted 3D-FLAIR. Magn Reson Med Sci. 2010;9(4):237–42.PubMedCrossRef
9.
10.
Liu F, Huang W, Wang Z, Chen Q, Liu X, Li S, et al. Noninvasive evaluation of endolymphatic space in healthy volunteers using magnetic resonance imaging. Acta Otolaryngol. 2011;131(3):247–57.PubMedCrossRef
11.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Imaging of Meniere’s disease by subtraction of MR cisternography from positive perilymph image. Magn Reson Med Sci. 2012;11(4):303–9.PubMedCrossRef
12.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Imaging of Meniere’s disease after intravenous administration of single-dose gadodiamide: utility of subtraction images with different inversion time. Magn Reson Med Sci. 2012;11(3):213–9.PubMedCrossRef
13.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Imaging of endolymphatic and perilymphatic fluid after intravenous administration of single-dose gadodiamide. Magn Reson Med Sci. 2012;11(2):145–50.PubMedCrossRef
14.
Nakashima T, Naganawa S, Teranishi M, Tagaya M, Nakata S, Sone M, et al. Endolymphatic hydrops revealed by intravenous gadolinium injection in patients with Meniere’s disease. Acta Otolaryngol. 2010;130(3):338–43.PubMedCrossRef
15.
Colletti V, Mandala M, Carner M, Barillari M, Cerini R, Pozzi Mucelli R, et al. Evidence of gadolinium distribution from the endolymphatic sac to the endolymphatic compartments of the human inner ear. Audiol Neurootol. 2010;15(6):353–63.PubMedCrossRef
16.
Kato K, Yoshida T, Teranishi M, Sano R, Otake H, Sone M, et al. Peak width in multifrequency tympanometry and endolymphatic hydrops revealed by magnetic resonance imaging. Otol Neurotol. 2012;33(6):912–5.PubMedCrossRef
17.
Fiorino F, Pizzini FB, Barbieri F, Beltramello A. Magnetic resonance imaging fails to show evidence of reduced endolymphatic hydrops in gentamicin treatment of Meniere’s disease. Otol Neurotol. 2012;33(4):629–33.PubMedCrossRef
18.
Gurkov R, Flatz W, Louza J, Strupp M, Krause E. In vivo visualization of endolymphatic hydrops in patients with Meniere’s disease: correlation with audiovestibular function. Eur Arch Otorhinolaryngol. 2011;268(12):1743–8.PubMedCrossRef
19.
Fukuoka H, Takumi Y, Tsukada K, Miyagawa M, Oguchi T, Ueda H, et al. Comparison of the diagnostic value of 3 T MRI after intratympanic injection of GBCA, electrocochleography, and the glycerol test in patients with Meniere’s disease. Acta Otolaryngol. 2012;132(2):141–5.PubMedCentralPubMedCrossRef
20.
Seo YJ, Kim J, Choi JY, Lee WS. Visualization of endolymphatic hydrops and correlation with audio-vestibular functional testing in patients with definite Meniere’s disease. Auris Nasus Larynx. 2013;40(2):167–72.PubMedCrossRef
21.
Katayama N, Yamamoto M, Teranishi M, Naganawa S, Nakata S, Sone M, et al. Relationship between endolymphatic hydrops and vestibular-evoked myogenic potential. Acta Otolaryngol. 2010;130(8):917–23.PubMedCrossRef
22.
Kato M, Teranishi M, Katayama N, Sone M, Naganawa S, Nakashima T. Association between endolymphatic hydrops as revealed by magnetic resonance imaging and caloric response. Otol Neurotol. 2011;32(9):1480–5.PubMedCrossRef
23.
Yoshida T, Teranishi M, Kato M, Otake H, Kato K, Sone M, et al. Endolymphatic hydrops in patients with tinnitus as the major symptom. Eur Arch Otorhinolaryngol. 2013;270(12):3043–8.
24.
Zou J, Pyykko I, Bjelke B, Dastidar P, Toppila E. Communication between the perilymphatic scalae and spiral ligament visualized by in vivo MRI. Audiol Neurootol. 2005;10(3):145–52.PubMedCrossRef
25.
Fang ZM, Chen X, Gu X, Liu Y, Zhang R, Cao DR, et al. A new magnetic resonance imaging scoring system for perilymphatic space appearance after intratympanic gadolinium injection, and its clinical application. J Laryngol Otol. 2012;126(5):454–9.PubMedCrossRef
26.
Fiorino F, Pizzini FB, Beltramello A, Barbieri F. Progression of endolymphatic hydrops in Meniere’s disease as evaluated by magnetic resonance imaging. Otol Neurotol. 2011;32(7):1152–7.PubMedCrossRef
27.
Fukuoka H, Tsukada K, Miyagawa M, Oguchi T, Takumi Y, Sugiura M, et al. Semi-quantitative evaluation of endolymphatic hydrops by bilateral intratympanic gadolinium-based contrast agent (GBCA) administration with MRI for Meniere’s disease. Acta Otolaryngol. 2010;130(1):10–6.PubMedCrossRef
28.
Gurkov R, Flatz W, Keeser D, Strupp M, Ertl-Wagner B, Krause E. Effect of standard-dose Betahistine on endolymphatic hydrops: an MRI pilot study. Eur Arch Otorhinolaryngol. 2013;270(4):1231–5.PubMedCrossRef
29.
Katahira N, Tanigawa T, Tanaka H, Nonoyama H, Ueda H. Diluted gadoteridol [ProHance(R)] causes mild ototoxicity in cochlear outer hair cells. Acta Otolaryngol. 2013;133(8):788–95.PubMedCrossRef
30.
Shi H, Li Y, Yin S, Zou J. The predominant vestibular uptake of gadolinium through the oval window pathway is compromised by endolymphatic hydrops in Meniere’s disease. Otol Neurotol. 2014;35(2):315–22.
31.
Nakashima T, Naganawa S, Katayama N, Teranishi M, Nakata S, Sugiura M, et al. Clinical significance of endolymphatic imaging after intratympanic gadolinium injection. Acta Otolaryngol Suppl. 2009;560:9–14.PubMedCrossRef
32.
Naganawa S, Satake H, Iwano S, Fukatsu H, Sone M, Nakashima T. Imaging endolymphatic hydrops at 3 tesla using 3D-FLAIR with intratympanic Gd-DTPA administration. Magn Reson Med Sci. 2008;7(2):85–91.PubMedCrossRef
33.
Naganawa S, Kawai H, Fukatsu H, Ishigaki T, Komada T, Maruyama K, et al. High-speed imaging at 3 Tesla: a technical and clinical review with an emphasis on whole-brain 3D imaging. Magn Reson Med Sci. 2004;3(4):177–87.PubMedCrossRef
34.
Naganawa S, Satake H, Kawamura M, Fukatsu H, Sone M, Nakashima T. Separate visualization of endolymphatic space, perilymphatic space and bone by a single pulse sequence; 3D-inversion recovery imaging utilizing real reconstruction after intratympanic Gd-DTPA administration at 3 Tesla. Eur Radiol. 2008;18(5):920–4.PubMedCrossRef
35.
Naganawa S, Sugiura M, Kawamura M, Fukatsu H, Sone M, Nakashima T. Imaging of endolymphatic and perilymphatic fluid at 3 T after intratympanic administration of gadolinium-diethylene-triamine pentaacetic acid. AJNR Am J Neuroradiol. 2008;29(4):724–6.PubMedCrossRef
36.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Estimation of perilymph enhancement after intratympanic administration of Gd-DTPA by fast T1-mapping with a dual flip angle 3D spoiled gradient echo sequence. Magn Reson Med Sci. 2013;12(3):223–8.PubMedCrossRef
37.
Naganawa S, Sone M, Yamazaki M, Kawai H, Nakashima T. Visualization of endolymphatic hydrops after intratympanic injection of Gd-DTPA: comparison of 2D and 3D real inversion recovery imaging. Magn Reson Med Sci. 2011;10(2):101–6.PubMedCrossRef
38.
Grieve SM, Obholzer R, Malitz N, Gibson WP, Parker GD. Imaging of endolymphatic hydrops in Meniere’s disease at 1.5 T using phase-sensitive inversion recovery: (1) demonstration of feasibility and (2) overcoming the limitations of variable gadolinium absorption. Eur J Radiol. 2012;81(2):331–8.PubMedCrossRef
39.
Naganawa S, Ishihara S, Iwano S, Sone M, Nakashima T. Three-dimensional (3D) visualization of endolymphatic hydrops after intratympanic injection of Gd-DTPA: optimization of a 3D-real inversion-recovery turbo spin-echo (TSE) sequence and application of a 32-channel head coil at 3T. J Magn Reson Imaging. 2010;31(1):210–4.PubMedCrossRef
40.
Liu F, Huang W, Meng X, Wang Z, Liu X, Chen Q. Comparison of noninvasive evaluation of endolymphatic hydrops in Meniere’s disease and endolymphatic space in healthy volunteers using magnetic resonance imaging. Acta Otolaryngol. 2012;132(3):234–40.PubMedCrossRef
41.
Pyykko I, Zou J, Poe D, Nakashima T, Naganawa S. Magnetic resonance imaging of the inner ear in Meniere’s disease. Otolaryngol Clin North Am. 2010;43(5):1059–80.PubMedCrossRef
42.
Louza J, Krause E, Gurkov R. Audiologic evaluation of Meniere’s disease patients one day and one week after intratympanic application of gadolinium contrast agent: our experience in sixty-five patients. Clin Otolaryngol. 2013;38(3):262–6.PubMedCrossRef
43.
Suzuki H, Teranishi M, Naganawa S, Nakata S, Sone M, Nakashima T. Contrast-enhanced MRI of the inner ear after intratympanic injection of meglumine gadopentetate or gadodiamide hydrate. Acta Otolaryngol. 2011;131(2):130–5.PubMedCrossRef
44.
Yoshioka M, Naganawa S, Sone M, Nakata S, Teranishi M, Nakashima T. Individual differences in the permeability of the round window: evaluating the movement of intratympanic gadolinium into the inner ear. Otol Neurotol. 2009;30(5):645–8.PubMedCrossRef
45.
Naganawa S, Kawai H, Sone M, Nakashima T. Increased sensitivity to low concentration gadolinium contrast by optimized heavily T2-weighted 3D-FLAIR to visualize endolymphatic space. Magn Reson Med Sci. 2010;9(2):73–80.PubMedCrossRef
46.
Naganawa S, Yamazaki M, Kawai H, Sone M, Nakashima T. Contrast enhancement of the anterior eye segment and subarachnoid space: detection in the normal state by heavily T2-weighted 3D FLAIR. Magn Reson Med Sci. 2011;10(3):193–9.PubMedCrossRef
47.
Carfrae MJ, Holtzman A, Eames F, Parnes SM, Lupinetti A. 3 Tesla delayed contrast magnetic resonance imaging evaluation of Meniere’s disease. Laryngoscope. 2008;118(3):501–5.PubMedCrossRef
48.
Tagaya M, Yamazaki M, Teranishi M, Naganawa S, Yoshida T, Otake H, et al. Endolymphatic hydrops and blood-labyrinth barrier in Meniere’s disease. Acta Otolaryngol. 2011;131(5):474–9.PubMedCrossRef
49.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Imaging of Meniere’s disease after intravenous administration of single-dose gadodiamide: utility of multiplication of MR cisternography and HYDROPS image. Magn Reson Med Sci. 2013;12(1):63–8.PubMedCrossRef
50.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Three-dimensional visualization of endolymphatic hydrops after intravenous administration of single-dose gadodiamide. Magn Reson Med Sci. 2013;12(2):147–51.PubMedCrossRef
51.
Zou J, Li M, Zhang Y, Zheng G, Chen D, Chen S, et al. Transport augmentation through the blood-inner ear barriers of guinea pigs treated with 3-nitropropionic acid and patients with acute hearing loss, visualized with 3.0 T MRI. Otol Neurotol. 2011;32(2):204–12.PubMedCrossRef
52.
Sano R, Teranishi M, Yamazaki M, Isoda H, Naganawa S, Sone M, et al. Contrast enhancement of the inner ear in magnetic resonance images taken at 10 min or 4 h after intravenous gadolinium injection. Acta Otolaryngol. 2012;132(3):241–6.PubMedCrossRef
53.
Naganawa S, Komada T, Fukatsu H, Ishigaki T, Takizawa O. Observation of contrast enhancement in the cochlear fluid space of healthy subjects using a 3D-FLAIR sequence at 3 Tesla. Eur Radiol. 2006;16(3):733–7.PubMedCrossRef
54.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Visualization of endolymphatic hydrops in Meniere’s disease after single-dose intravenous gadolinium-based contrast medium: timing of optimal enhancement. Magn Reson Med Sci. 2012;11(1):43–51.PubMedCrossRef
55.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T. Visualization of endolymphatic hydrops in Ménière’s disease after intravenous administration of single-dose gadodiamide at 1.5T. Magn Reson Med Sci. 2013;12(2):137–9.PubMedCrossRef
56.
Nakashima T, Sone M, Teranishi M, Yoshida T, Terasaki H, Kondo M, et al. A perspective from magnetic resonance imaging findings of the inner ear: relationships among cerebrospinal, ocular and inner ear fluids. Auris Nasus Larynx. 2012;39(4):345–55.PubMedCrossRef
57.
Pyykko I, Nakashima T, Yoshida T, Zou J, Naganawa S. Meniere’s disease: a reappraisal supported by a variable latency of symptoms and the MRI visualisation of endolymphatic hydrops. BMJ Open. 2013;3(2). doi:10.​1136/​bmjopen-2012-001555.
58.
Naganawa S, Suzuki K, Nakamichi R, Bokura K, Yoshida T, Sone M et al. Semi-quantification of endolymphatic size on MR imaging after intravenous injection of single-dose gadodiamide: comparison between two types of processing strategies. Magn Reson Med Sci. 2013.
59.
Naganawa S, Suzuki K, Yamazaki M, Sakurai Y, Ikeda M. Time course of endolymphatic size measurement in healthy volunteers following intravenous administration of gadoteridol. Magn Reson Med Sci. (in press).
60.
Tanigawa T, Tamaki T, Yamamuro O, Tanaka H, Nonoyama H, Shiga A, et al. Visualization of endolymphatic hydrops after administration of a standard dose of an intravenous gadolinium-based contrast agent. Acta Otolaryngol. 2011;131(6):596–601.PubMedCrossRef
61.
Tagaya M, Teranishi M, Naganawa S, Iwata T, Yoshida T, Otake H, et al. 3 Tesla magnetic resonance imaging obtained 4 h after intravenous gadolinium injection in patients with sudden deafness. Acta Otolaryngol. 2010;130(6):665–9.PubMedCrossRef
62.
Naganawa S, Ishihara S, Iwano S, Sone M, Nakashima T. Detection of presumed hemorrhage in the ampullar endolymph of the semicircular canal: a case report. Magn Reson Med Sci. 2009;8(4):187–91.PubMedCrossRef
63.
Naganawa S, Sone M, Otake H, Nakashima T. Endolymphatic hydrops of the labyrinth visualized on noncontrast MR imaging: a case report. Magn Reson Med Sci. 2009;8(1):43–6.PubMedCrossRef
64.
Naganawa S, Kawai H, Sone M, Nakashima T, Ikeda M. Endolympathic hydrops in patients with vestibular schwannoma: visualization by non-contrast-enhanced 3D FLAIR. Neuroradiology. 2011;53(12):1009–15.PubMedCrossRef
65.
Iida T, Teranishi M, Yoshida T, Otake H, Sone M, Kato M, et al. Magnetic resonance imaging of the inner ear after both intratympanic and intravenous gadolinium injections. Acta Otolaryngol. 2013;133(5):434–8.PubMedCrossRef
66.
Naganawa S, Yamazaki M, Kawai H, Bokura K, Iida T, Sone M et al. MR imaging of Ménière’s disease by both intratympanic and intravenous injection of gadolinium using HYDROPS2. Magn Reson Med Sci. (in press).
67.
Nakashima T, Naganawa S, Pyykko I, Gibson WP, Sone M, Nakata S, et al. Grading of endolymphatic hydrops using magnetic resonance imaging. Acta Otolaryngol Suppl. 2009;560:5–8.PubMedCrossRef
68.
Teranishi M, Yoshida T, Katayama N, Hayashi H, Otake H, Nakata S, et al. 3D computerized model of endolymphatic hydrops from specimens of temporal bone. Acta Otolaryngol Suppl. 2009;560:43–7.PubMedCrossRef
69.
Yamamoto M, Teranishi M, Naganawa S, Otake H, Sugiura M, Iwata T, et al. Relationship between the degree of endolymphatic hydrops and electrocochleography. Audiol Neurootol. 2010;15(4):254–60.PubMedCrossRef
70.
Gurkov R, Flatz W, Louza J, Strupp M, Ertl-Wagner B, Krause E. In vivo visualized endolymphatic hydrops and inner ear functions in patients with electrocochleographically confirmed Meniere’s disease. Otol Neurotol. 2012;33(6):1040–5.PubMed
71.
Fiorino F, Pizzini FB, Beltramello A, Barbieri F. MRI performed after intratympanic gadolinium administration in patients with Meniere’s disease: correlation with symptoms and signs. Eur Arch Otorhinolaryngol. 2011;268(2):181–7.PubMedCrossRef
72.
Sone M, Naganawa S, Teranishi M, Nakata S, Katayama N, Nakashima T. Changes in endolymphatic hydrops in a patient with Meniere’s disease observed using magnetic resonance imaging. Auris Nasus Larynx. 2010;37(2):220–2.PubMedCrossRef
73.
Uno A, Imai T, Watanabe Y, Tanaka H, Kitahara T, Horii A, et al. Changes in endolymphatic hydrops after sac surgery examined by Gd-enhanced MRI. Acta Otolaryngol. 2013;133(9):924–9.PubMedCrossRef
74.
Bauer PW, MacDonald CB, Cox LC. Intratympanic gentamicin therapy for vertigo in nonserviceable ears. Am J Otolaryngol. 2001;22(2):111–5.PubMedCrossRef
75.
Fiorino F, Pizzini FB, Barbieri F, Beltramello A. Variability in the perilymphatic diffusion of gadolinium does not predict the outcome of intratympanic gentamicin in patients with Meniere’s disease. Laryngoscope. 2012;122(4):907–11.PubMedCrossRef
76.
Horii A, Osaki Y, Kitahara T, Imai T, Uno A, Nishiike S, et al. Endolymphatic hydrops in Meniere’s disease detected by MRI after intratympanic administration of gadolinium: comparison with sudden deafness. Acta Otolaryngol. 2011;131(6):602–9.PubMedCrossRef
77.
Nonoyama H, Tanigawa T, Tamaki T, Tanaka H, Yamamuro O, Ueda H. Evidence for bilateral endolymphatic hydrops in ipsilateral delayed endolymphatic hydrops: preliminary results from examination of five cases. Acta Otolaryngol. 2013 [Epub ahead of print].
78.
Gurkov R, Kantner C, Strupp M, Flatz W, Krause E, Ertl-Wagner B. Endolymphatic hydrops in patients with vestibular migraine and auditory symptoms. Eur Arch Otorhinolaryngol. 2013 [Epub ahead of print].
Metadata
Title
Visualization of endolymphatic hydrops with MR imaging in patients with Ménière’s disease and related pathologies: current status of its methods and clinical significance
Authors
Shinji Naganawa
Tsutomu Nakashima
Publication date
01-04-2014
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 4/2014
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-014-0290-4

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