Magnetic resonance imaging of endolymphatic hydrops in patients with unilateral Meniere’s disease: a comparison between with and without herniation into the posterior and lateral semi-circular canals

Abstract

Background

The presence of endolymphatic hydrops (ELH) in patients with Meniere’s disease (MD) is considered a pathological hallmark.

Aims/objectives

We aimed to conduct a quantitative volumetric measurement of inner ear ELH in patients with unilateral MD (uMD). The values of uMD with and without herniation into the posterior semi-circular canal (h-PSC) and the lateral semi-circular canal (h-LSC) were compared using 3 D magnetic resonance imaging.

Material and methods

This study included 130 individuals (47 controls and 83 patients with uMD). We measured the total fluid space (TFS) and endolymphatic space (ELS) volumes. We also evaluated the ELS/TFS volume ratios (%).

Results

The ELS/TFS volume ratios in the inner ear, cochlea, and vestibule were significantly different between the affected and contralateral sides in patients with h-PSC. Moreover, the ELS/TFS volume ratios of the inner ear, vestibule, and semi-circular canals in the affected ear were significantly higher in patients with h-PSC than in those without h-PSC. The vestibular ELS/TFS volume ratio in the affected ear was significantly higher in patients with h-LSC than in those without h-LSC.

Conclusions and significance

H-LSC is present in extended vestibular ELH. However, this is a result of ELH progression in the inner ear.

Chinese abstract

背景：美尼尔氏病（MD）患者有内淋巴积水（ELH）被认为是病理标志。

目的：我们旨在对单侧MD（uMD）患者的内耳ELH进行定量体积测量。使用3D磁共振成像比较带或不带疝的半规管（h-PSC）和外侧半规管（h-LSC）的uMD值。

材料和方法：这项研究包括130名参与者（47名对照者和83名uMD患者）。我们测量了总流体空间（TFS）和内淋巴空间（ELS）的体积。我们还评估了ELS / TFS体积比（％）。

结果：h-PSC患者的患侧和对侧之间的内耳、耳蜗和前庭的ELS / TFS体积比显著不同。此外, 受累耳朵的内耳、前庭和半圆形管的ELS / TFS体积比, 有h-PSC的患者比没有h-PSC的患者明显更高。前庭ELS / TFS体积比, h-LSC患者的患病耳朵明显高于无h-LSC的患者。

结论和意义：H-LSC存在于扩展的前庭ELH中。然而, 这是内耳ELH发展的结果。

Keywords:

• Endolymphatic hydrops
• herniation
• lateral semi-circular canal
• magnetic resonance imaging
• Meniere’s disease
• posterior semi-circular canal
• volumetric measurement

Acknowledgments

We would like to thank Prof. Kimihiro Kichikawa, Dr. Toshiteru Miyasaka (Department of Radiology, Nara Medical University, Nara, Japan), Prof. Shinji Naganawa, and Associate Prof. Toshiaki Taoka (Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan). We would also like to thank Dr. Hitoshi Yoshimura, Dr. Masahiko Sakamoto, other collaborators (Department of Radiology, Kouseikai Takai Hospital), and Mrs. Yuka Katsube (Inui ENT Clinic) for data aggregation. We would like to thank Editage (www.editage.com) for English language editing.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.