Abstract
Background: Delayed 3D-FLAIR sequences enable the distinction between the utricle and the saccule.
Aims/objectives: We sought to evaluate the clinical and radiological findings in patients with no visible saccule (NVS) on 4-hour post-contrast MRI.
Material and Methods: We retrospectively assessed the presence of NVS signs in 400 patients who underwent delayed inner ear MRI.
Results: We reported on 28 patients with NVS. Among this group, on the NVS affected side: 14 had isolated sensorineural hearing loss (SNHL); 4 had fluctuating cochleo-vestibular disease; 3 had definite Menière’s disease; 3 had Minor syndrome; 2 had delayed endolymphatic hydrops (EH); 2 had inner ear malformations; 1 had sudden cochleo-vestibular deficit following stapes surgery; 1 had a perilymphatic fistula and 1 had a contralateral fluctuating SNHL. Sixteen out of these 28 patients (57.1%) had cochlear hydrops on the same side as the NVS, while 10 patients (35.7%) had saccular hydrops on the contralateral side. Moreover, isolated blood labyrinth barrier (BLB) impairment on the NVS side was observed in 7 patients. Two patients (7.1%) had large vestibular aqueduct and NVS on the same side and one patient had perilymphatic fistula.
Conclusions and significance: NVS seems to be multifactorial and could be linked to hydropic ear disease, third-mobile window pathologies and congenital malformation.
Chinese abstract
背景:延迟的3D-FLAIR序列可以用来区分胞囊和球囊。
目的:探讨无可见球囊(NVS)的患者在4小时后增强磁共振成像(MRI)上的临床和影像学表现。
材料与方法:回顾性分析400例接受延迟内耳MRI检查的的患者的NVS征象。
结果:我们报告了28例NVS患者。这群患者的NVS患侧:14例有孤立性感觉神经性听力损失(SNHL);4例患有波动性耳蜗前庭病;3例有明确的梅尼埃病;3例有轻微综合征;2例有迟发性内淋巴积水(EH);2例有内耳畸形;1例镫骨手术后突然出现耳蜗前庭缺损;1例有外淋巴瘘, 1例有对侧SNHL波动。28例患者中16例(57.1%)在NVS一侧有耳蜗积水, 10例(35.7%)对侧有囊状积水。7例NVS侧出现孤立性血迷路屏障(BLB)损伤。两位患者(7.1%)的大前庭导水管和NVS在同一侧;一位患者有外淋巴瘘。
结论和意义:NVS可能是多因素的, 可能与耳积水病、第三活动窗病变和先天畸形有关。
Disclosure statement
The authors report no conflict of interest.