Comparison between high-resolution 3D-IR with real reconstruction and 3D-flair sequences in the assessment of endolymphatic hydrops in 3 tesla

Abstract

Background

The main sequences used to assess degree of endolymphatic hydrops (EH) are the 3D- inversion-recovery (IR) with real reconstruction and the 3D- fluid-attenuated inversion recovery (FLAIR).

Objectives

The purpose of this study is to describe and compare both sequences.

Material and methods

Forty-two consecutive patients diagnosed with probable or definite Ménièr´s disease were referred for hydrops MR examination. Vestibular and cochlear EH in both sequences were read by two independent radiologists, unaware of the patient’s clinical status. The primary study endpoint was the concordance in the hydrops detection and severity with both imaging sequences. This was assessed using the Cohen's kappa Κ statistic for disease grading and Pearson Χ² test to test the difference in detection rates of hydrops. Statistical significance was defined as two-sided p < .05.

Results

We obtained an excellent overall concordance, with a kappa of 0.821, (p < .001) when comparing hydrops detection. The degree of concordance is higher in vestibular hydrops than in cochlear hydrops. The 3D-IR sequence detected more hydrops than the 3D FLAIR, (62 vs. 39.5%, p < .03).

Conclusion

The 3D-IR sequence seems to be superior to the 3D-FLAIR for the assessment of EH.

Significance: The 3D-IR sequence should be considered as a standalone parameter for a shorter and optimized EH magnetic resonance imaging protocol.

Chinese abstract

背景：用于评估内淋巴积液（EH）程度的主要测序是具有真实重建的3D反转恢复（IR）和3D减液反转恢复（FLAIR）。

目的：本研究的目的是描述和比较两种测序。

材料和方法：42例被诊断为可能或确定的梅尼埃病的连续患者被转诊进行积液MR检查。两种测序的前庭和耳蜗EH由两名独立的放射科医生解读。他们对患者的临床状况并不了解。初步研究终点是两个影像学测序在积水检测和严重程度上的一致性。使用Cohen的kappa K统计量进行疾病分级和Pearson X2检验进行评估积液检出率的差异。统计显著性定义为双面p <.05。

结果：比较积液检测时, 我们获得了极好的总体一致性, kappa为0.821（p <.001）。前庭积水的一致性高于耳蜗积水。 3D-IR序列比3D FLAIR检测到更多的积液（62 vs. 39.5％, p <.03）。

结论：在评估EH方面, 3D-IR测序似乎优于3D-FLAIR。

意义：3D-IR测序应被视为较短的且优化的EH磁共振成像规约的独立参数。

Keywords:

• Endolymphatic
• hydrops
• Menière
• FLAIR
• 3D-IR-Real

Acknowledgments

The authors would like to thank Dr. Pérez for coordination and mentorship during the study and Dr. Leal for statistical analysis.

Disclosure statement

The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.