Intratympanic Contrast in the Evaluation of Menière Disease: Understanding the Limits

Studies describing endolymphatic hydrops in Menière disease after off-label intratympanic gadolinium-based contrast have been limited by long acquisition times. We aimed to demonstrate the feasibility of post-intratympanic imaging on a 3T MR imaging system within a clinically tolerable acquisition t...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2015-07, Vol.36 (7), p.1326-1332
Main Authors: Bykowski, J, Harris, J P, Miller, M, Du, J, Mafee, M F
Format: Article
Language:English
Subjects:
Adult
Contrast Media - administration & dosage
Female
Gadolinium DTPA - administration & dosage
Head & Neck
Humans
Injection, Intratympanic
Magnetic Resonance Imaging - methods
Male
Meniere Disease - diagnosis
Middle Aged
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Summary:Studies describing endolymphatic hydrops in Menière disease after off-label intratympanic gadolinium-based contrast have been limited by long acquisition times. We aimed to demonstrate the feasibility of post-intratympanic imaging on a 3T MR imaging system within a clinically tolerable acquisition time and to address potential pitfalls in acquisition or interpretation. FDA Investigational New Drug 115,342 and institutional review board approval were obtained for intratympanic injection of 8-fold diluted Gd-DTPA into the more symptomatic ear of 6 adults with Menière disease. 3T MR imaging was performed using a 3-inch surface coil before and up to 28 hours after injection using FLAIR to define the nonenhancing endolymphatic space within the enhancing perilymph. Variable FLAIR TI images were used to determine the impact of fluid-suppression on interpretation. Image quality was assessed for perilymphatic and extralabyrinthine contrast enhancement, definition of endolymphatic anatomy, and other anatomic variants or pathologic findings. The surface coil afforded 0.375 × 0.375 mm in-plane FLAIR resolution in
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A4277