Endolymphatic hydrops and therapeutic effects are visualized in 'atypical' Meniere's disease.
A 53-year-old male with fluctuating low frequency sensorineural hearing loss and tinnitus, but without vertigo, was evaluated by MRI obtained by intratympanic injection of a gadolinium-based contrast agent (GBCA) before and after the administration of isosorbide. The endolymphatic hydrops was semi-quantitatively evaluated by a 3.0-T MR scanner. For quantification, the affected side/contralateral side ratios were calculated. A gadodiamide (a kind of GBCA)-enhanced space surrounding the endolymph in the affected side with a 0.50 ratio (which may have represented endolymphatic hydrops) improved after isosorbide therapy to a 0.98 ratio. Thus, endolymphatic hydrops was demonstrated in a patient with 'atypical' Meniere's disease (MD), suggesting that at least some atypical MD may share similar etiology with, and therefore be a continuum of, MD. Also, therapeutic effects could be visualized by using MRI. Therefore, MRI-based diagnosis of MD-related disease will be a powerful tool not only because of its precision but also its usefulness for therapeutic evaluation.
Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.
Maiko
M
Miyagawa
Hisakuni
H
Fukuoka
Keita
K
Tsukada
Tomohiro
T
Oguchi
Yutaka
Y
Takumi
Makoto
M
Sugiura
Hitoshi
H
Ueda
Masumi
M
Kadoya
Shin-ichi
S
Usami
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage; D004234:Diuretics, Osmotic / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004710:Endolymph / Q000187:drug effects; D018159:Endolymphatic Hydrops / Q000175:diagnosis* / Q000188:drug therapy*; D019786:Gadolinium DTPA; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000031:analogs & derivatives; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D007547:Isosorbide / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000188:drug therapy*; D008875:Middle Aged; D010498:Perilymph / Q000187:drug effects; D014012:Tinnitus / Q000209:etiology
D000893:Anti-Inflammatory Agents; D003287:Contrast Media; D004234:Diuretics, Osmotic; C064925:gadodiamide; D019786:Gadolinium DTPA; C007133:hydrocortisone hemisuccinate; D006854:Hydrocortisone; D007547:Isosorbide