Endolymphatic space imaging in patients with delayed endolymphatic hydrops.
CONCLUSIONS
Magnetic resonance imaging (MRI) after intratympanic gadolinium injection can reveal endolymphatic hydrops (ELH) in patients with delayed ELH (DELH). Patients with contralateral DELH may have bilateral ELH.


OBJECTIVE
DELH has previously been diagnosed based on clinical history, hearing and vestibular examinations. DELH is classified into three types: ipsilateral, contralateral and bilateral indicate the side with the longstanding hearing loss. Ipsilateral DELH occurs in the ear with a profound hearing loss, contralateral DELH in the better hearing ear and bilateral DELH in both ears. Imaging diagnosis of the endolymphatic space may add a new dimension to the diagnosis and treatment of DELH.


METHODS
Gadodiamide hydrate was diluted eightfold with saline. The diluted gadodiamide hydrate was injected intratympanically through the tympanic membrane in two patients with ipsilateral DELH and five patients with contralateral DELH. One day after the injection, 3 Tesla MRI was performed to evaluate the endolymphatic space.


RESULTS
ELH was observed in all patients. In three patients who underwent bilateral intratympanic injection of gadolinium and were diagnosed with contralateral DELH, ELH was observed bilaterally. In one of these three patients, ELH was observed in the cochlea on the left and in the vestibule on the right.
Department of Otorhinolaryngology, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan.
Sachio
S
Kasai
Masaaki
M
Teranishi
Naomi
N
Katayama
Makoto
M
Sugiura
Seiichi
S
Nakata
Michihiko
M
Sone
Shinji
S
Naganawa
Tsutomu
T
Nakashima
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D018159:Endolymphatic Hydrops / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D019786:Gadolinium DTPA; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000473:pathology; D046088:Hearing Loss, Unilateral / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017084:Otoacoustic Emissions, Spontaneous; D014717:Vertigo / Q000175:diagnosis / Q000473:pathology; D014724:Vestibular Function Tests; D014722:Vestibule, Labyrinth / Q000473:pathology*
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA