Characteristic MR findings suggesting presumed labyrinthine hemorrhage

Abstract

Objectives: To evaluate the magnetic resonance imaging (MRI) findings of labyrinthine hemorrhage as a cause of sudden sensorineural hearing loss (SSNHL).

Methods: MRI scans of 59 patients with SSNHL were retrospectively analyzed and compared to clinical features and audiometry data. MR images included pre-enhanced T1-weighted, 3D FLAIR volume isometric turbo spin-echo acquisition (VISTA), post-enhanced T1-weighted and 4-h-delayed enhanced FLAIR VISTA, and 3D thin-section proton density-weighted images.

Results: High labyrinth signals were seen on pre-enhanced T1-weighted and 3D FLAIR VISTA images with no enhancement for 6 of 59 (10.2%) patients with SSNHL. In these six patients with presumed inner-ear hemorrhage, high signal intensity was seen in the endolymphatic and perilymphatic portions of the labyrinth on T1-weighted and 3D FLAIR VISTA images. In patients with SSNHL with nonhemorrhagic causes such as vestibular schwannoma or labyrinthitis, high signal or labyrinthine enhancement was seen only in the perilymphatic portion of the labyrinth on pre- or post-enhanced 3D FLAIR VISTA images.

Conclusions: MRI using pre-enhanced T1-weighted, 3D FLAIR VISTA, and post-enhanced T1-weighted, 4-h delayed enhanced FLAIR VISTA images is able to identify labyrinthine hemorrhage as the cause of SSNHL. High signals in both the endolymphatic and perilymphatic portions of the labyrinth on pre- or post-enhanced 3D FLAIR VISTA images without enhancement indicate labyrinthine hemorrhage.

Chinese abstract

目的：评估磁共振成像（MRI）发现迷路出血是导致突发性感觉神经性听力损失（SSNHL）的原因。

方法：对59例SSNHL患者的MRI扫描进行回顾性分析, 并与临床特征和听力数据进行比较。 MR图像包括预增强T1加权、三维 FLAIR VISTA、后增强T1加权和4小时延迟增强FLAIR VISTA和三维薄截面质子密度加权图像。

结果：59例（10.2％）SSNHL患者中6例的未增强T1增强型和三维FLAIR VISTA图像上, 观察到高迷路信号。对于这六名推测患有内耳出血的患者中, 在T1加权和三维FLAIR VISTA图像上的迷路的内淋巴和外淋巴部分中观察到高信号强度。在具有非出血性原因如前庭神经鞘瘤或迷路炎的SSNHL患者中, 仅在前或后增强的三维 FLAIR VISTA图像的迷路的外淋巴部分才能看到高信号或迷路增强。

结论：使用预增强T1加权、三维 FLAIR体积等长涡旋自旋回波采集（VISTA）和后增强T1加权, 4 小时延迟增强FLAIR VISTA图像的MRI能够确定迷路出血是导致SSNHL的原因。前或后增强的三维FLAIR VISTA图像上, 迷路的内淋巴和外淋巴部分的高信号标志着迷路出血。

Keywords:

• Inner ear
• sensorineural hearing loss
• labyrinth hemorrhage
• endolymphatic and perilymphatic space
• 3D FLAIR VISTA

Disclosure statement

The authors report no conflicts of interest.