著者

中島 務 寺西 正明 片山 直美 加藤 正大

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.3, pp.197-203, 2011 (Released:2011-08-01)

参考文献数

28

---

The first visualization of endolymphatic hydrops in patients with Ménière's disease was performed using three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging with a 3 Tesla MRI unit after gadolinium contrast agent (Gd) was injected intratympanically. The 3D-FLAIR MRI could differentiate the endolymphatic space from the perilymphatic space, but not from the surrounding bone. By optimizing the inversion time, the endolymphatic space, perilymphatic space and surrounding bone could be separately visualized on a single image using three-dimensional real inversion recovery (3D-real IR) MRI. Using 3D-FLAIR and 3D-real IR MRI, various degrees of endolymphatic hydrops were observed in the basal and upper turns of the cochlea and in the vestibular apparatus after intratympanic Gd injection. Recently, visualization of endolymphatic hydrops became possible 4 h after intravenous Gd injection in patients with Ménière's disease. We applied a heavily T(2)—weighted 3D-FLAIR technique to detect Gd more sensitively for evaluation of endolymphatic hydrops after an ordinary amount of Gd was administered intravenously. Thus, newly developed MRI techniques have contributed significantly to the evaluation of endolymphatic hydrops. The intravenous administration of an ordinary amount of Gd is routinely done clinically. The relationship between endolymphatic hydrops and clinical symptoms will be investigated widely using new techniques.

著者

吉田 忠雄 加藤 正大 大竹 宏直 加藤 健 寺西 正明 片山 直美 中島 務

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium research (ISSN:03855716)

巻号頁・発行日

vol.72, no.4, pp.247-253, 2013-08-01

被引用文献数

3

---

Development of 3-tesla enhanced magnetic resonance imaging (MRI) provides a tool for the visualization of endolymphatic hydrops (EH). This technique was first developed in animal experiments and adapted in patients with inner ear diseases including Menieres disease (MD). Up to the present, we have demonstrated EH in many MD patients. Recently, we have succeeded in obtaining a 3D-real IR-like image even after intravenous standard-dose gadolinium administration. This type of image was named the HYDROPS (HYbriD of Reversed image Of Positive endolymph Signal and native image of positive perilymph signal). The relationship between unilateral MD and EH has not yet been explored. We studied 76 patients with unilateral MD who were evaluated using MRI. The mean age of the subjects was 53.4 years (range 17 to 80 years). Forty-two were women and 34 were men. Symptomatic and non-symptomatic ears were categorized into 4 groups (healthy, 76; possible, 48; Probable, 13; and definite, 15) based on AAO-HNS definitions. MRI was performed 4 hours after intravenous gadolinium administration. Overall, 152 ears were evaluated. EH in the cochlea was present in 57 of 76 symptomatic ears (73.7%) and 34 of 76 (44.7%) non symptomatic ears. Ears with definite MD had EH more frequently in the cochlea than ears in the healthy ears groups. Furthermore, EH in the vestibule with definite MD was larger than ears in any of the other groups. Our reports showed for the first time that there was Ba relationship between the degrees of EH and the stage of MD. Moreover, in fewer than half of unilateral MD patients EH was seen in the cochlea with non-symptomatic ears. EH in healthy ears may be an indicator of bilateral MD. Using MRI to identify this covert EH in asymptomatic patients may offer the possibility of early detection or prevention of MD.