Three-dimensional Fourier transformation constructive interference in steady state magnetic resonance imaging of the inner ear in patients with unilateral and bilateral Menière's disease.
OBJECTIVE
In this study, three-dimensional Fourier transformation constructive interference in steady state (3DFT-CISS) magnetic resonance imaging was used to quantify the distance between the vertical part of the posterior semicircular canal and the posterior fossa as a measure of the endolymphatic sac and duct in patients with Menière's disease. Differences in this distance between affected and unaffected ears, as well as differences between unilaterally and bilaterally affected patients, were studied and compared with a control group. Also, possible correlations between the measured distance and the duration and severity of symptoms, patient age, and average hearing loss were investigated in the group of patients with Menière's disease.


METHODS
Retrospective clinical study.


METHODS
Tertiary referral center (University Hospital) as part of a large, diagnostic research project on Menière's disease.


METHODS
Of the 111 patients with Menière's disease initially included, 90 patients underwent 3DFT-CISS MRI. Eighty-six of these patients were analyzed in this MRI study. Fifty-six patients had unilateral Menière's disease, and 30 patients had bilateral Menière's disease (116 affected and 56 unaffected ears). Sixty-two ears in patients without Menière's disease were studied as controls.


METHODS
The distance between the vertical part of the posterior semicircular canal and the posterior fossa was determined by 3DFT-CISS MRI.


METHODS
Contiguous axial 3DFT-CISS MRI slices of 0.7 to 1.0 mm were made by a radiologist according to a strict protocol. Measurements of the distance between the vertical part of the posterior semicircular canal and the posterior fossa were taken by two professionals-a radiologist and an otolaryngologist-using a ruler and the original scan.


RESULTS
A significantly smaller distance (2.9 mm) between the vertical part of the posterior semicircular canal and the posterior fossa as visualized on MRI scans was found in the ears of patients with Menière's disease than in the ears of patients in the control group (3.8 mm, p < 0.001). In both uni- and bilaterally affected patients (n = 56 and n = 30, respectively), no significant difference between ears was found (p = 0.44 and p = 0.19, respectively). In bilaterally affected patients, however, this distance (3.2 mm) was significantly greater than the distance in unilaterally affected patients (2.7 mm, p = 0.004). There was no relationship between the MRI-visualized distance between the vertical part of the posterior semicircular canal and the posterior fossa and the duration of disease, average hearing loss, or severity of symptoms in uni- and bilaterally affected patients.


CONCLUSIONS
The difference in MRI-visualized distances between the vertical part of the posterior semicircular canal and the posterior fossa of uni- and bilaterally affected patients strongly suggests that unilateral and bilateral hearing loss are two different entities in patients with Menière's disease. The size of the endolymphatic sac seems not to be the only factor in the pathogenesis of Menière's disease. That the MRI-visualized distance between the vertical part of the posterior semicircular canal and the posterior fossa does not have any relationship to the duration of the disease or to patient age indicates that this distance is a congenital feature.
Mateijsen
D J M
DJ
Departments of Otorhinolaryngology and Radiology, University Hospital Groningen, Groningen, The Netherlands. d.j.m.mateijsen@kno.azg.nl
Van Hengel
P W J
PW
Krikke
A P
AP
Van Huffelen
W M
WM
Wit
H P
HP
Albers
F W J
FW
D007758:Ear, Inner / Q000473:pathology*; D004432:Ear, Middle / Q000033:anatomy & histology; D004487:Edema / Q000473:pathology; D004712:Endolymphatic Sac / Q000473:pathology*; D005154:Facial Nerve / Q000033:anatomy & histology; D005583:Fourier Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008575:Meniere Disease / Q000175:diagnosis*; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000033:anatomy & histology; D000159:Vestibulocochlear Nerve / Q000033:anatomy & histology