The value of 3D-real IR MRI with intravenous gadolinium injection in the diagnosis of suspected Meniere’s disease in children

Abstract

Background

Intravenous gadolinium injection (IV-method) can be used to visualize endolymphatic hydrops.

Aims/objectives

This study was designed to use a three-dimensional inversion-recovery sequence with real reconstruction (3 D-real IR) sequence 4 h after the IV-method, images of the perilymph space were scored for endolymphatic hydrops in cases of suspected Meniere’s disease (MD) in children to investigate its diagnostic value of MD in children.

Materials and methods

We collected 28 suspected MD children aged ≤17 years old, all of whom underwent the IV-method. After 4 h, inner ear 3 D-real IR magnetic resonance imaging (MRI) was performed and results were analyzed.

Results

Gadolinium contrast agent was seen distributed in the perilymphatic space with perilymphatic enhancement on 3 D-real IR MRI, allowing differentiation between the perilymphatic and endolymphatic spaces. Based on perilymph MRI diagnostic scoring, 64.3% (18/28) of the patients were categorized as having endolymphatic hydrops, who were followed and eventually diagnosed with confirmed MDs.

Conclusions and significance

Suspected MD children should undergo gadolinium-enhanced examinations of the inner ear while taking dynamic audiology examinations for the confirmed diagnosis.

Chinese abstract

背景：静脉注射钆（IV法）可用于将内淋巴积液可视化。

目的：本研究的目的是, 在IV法后4小时, 采用具真实重建（3 D真实IR）序列的三维反转恢复序列, 对疑患梅尼埃病（MD）的未成年人进行周淋巴间隙图像评分以检测内淋巴积液, 调查该法对未成年人MD的诊断价值。

材料和方法：我们招纳了28名≤17岁的疑患MD未成年人, 他们全部接受了静脉注射钆, 4小时后, 进行内耳3D真实IR磁共振成像（MRI）并分析结果。

结果：在3D真实IR磁共振成像上发现钆造影剂分布在周淋巴间隙中, 并且在周淋巴间隙增强的情况下, 可以区分周淋巴间隙和内淋巴间隙。根据周淋巴MRI诊断评分, 有64.3％（18/28）的患者为被归类为具有内淋巴积水, 随后被随访并最终被确诊为MD。

结论和意义：疑患MD未成年人应在进行动态听力检查时进行钆增强内耳检查以达到确诊的目的。

Keywords:

• Suspected diagnosis
• Meniere’s disease
• children
• intravenous gadolinium injection
• 3D-real IR

SUBJECT CLASSIFICATION CODE:

• 320.41

Acknowledgments

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

Author contributions

Wei Chen conceived and designed research; Yuanyuan Chen and Yue Geng collected data and conducted research; Naier Lin and Sihui Yu wrote the initial paper; Zhengyue Wang and Siqi Luo revised the paper; Yan Sha had primary responsibility for the final content. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).