title: Clinical significance of endolymphatic imaging after intratympanic gadolinium injection.
abstract: CONCLUSIONS
  Using three-dimensional real inversion recovery (3D-real IR) and three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI), various degrees of endolymphatic hydrops were observed in the basal and upper turns of the cochlea and in the vestibular apparatus after intratympanic gadolinium (Gd) injection. MRI may contribute to our understanding of inner ear diseases and may be a useful addition to intratympanic drug therapy in the management of inner ear diseases.
  
  
  OBJECTIVE
  To evaluate 3D-real IR MRI and 3D-FLAIR MRI with clinical symptoms and signs in patients with inner ear disease.
  
  
  METHODS
  Gd was diluted in saline and injected intratympanically in 73 patients with inner ear disease. The endolymphatic space was evaluated with 3-Tesla MRI at 1 day after the intratympanic Gd injection.
  
  
  RESULTS
  3D-real IR MRI was generally better than 3D-FLAIR MRI in discriminating between the perilymphatic space and endolymphatic space in the cochlear turns and in the vestibular apparatus. However, when Gd concentration was insufficient in the perilymph, it was more difficult to visualize the Gd with 3D-real IR MRI than with 3D-FLAIR MRI. Endolymphatic hydrops was observed using MRI in patients with 'probable' Meniere's disease based on the criteria.
authors.affiliation: Department of Otorhinolaryngology, Nagoya University School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. tsutomun@med.nagoya-u.ac.jp
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
authors.forename: Naomi
authors.initials: N
authors.lastname: Katayama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Teranishi
authors.forename: Seiichi
authors.initials: S
authors.lastname: Nakata
authors.forename: Makoto
authors.initials: M
authors.lastname: Sugiura
authors.forename: Michihiko
authors.initials: M
authors.lastname: Sone
authors.forename: Sachio
authors.initials: S
authors.lastname: Kasai
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yoshioka
authors.forename: Masako
authors.initials: M
authors.lastname: Yamamoto
mesh_terms: D003051:Cochlea / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D018159:Endolymphatic Hydrops / Q000209:etiology / Q000473:pathology*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007267:Injections; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014432:Tympanic Membrane; D014722:Vestibule, Labyrinth / Q000473:pathology
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA