title: Analysis of the 3-dimensional fluid-attenuated inversion-recovery (3D-FLAIR) sequence in idiopathic sudden sensorineural hearing loss.
abstract: OBJECTIVE
  The unpredictability of idiopathic sudden sensorineural hearing loss (ISSNHL) presents a challenge to preventive care. Our study confirms the potentially important role of the 3-T magnetic resonance imaging (MRI), and in particular of the 3-dimensional fluid-attenuated inversion-recovery (3D-FLAIR) sequence, in the diagnosis and prognosis of ISSNHL to guide medical treatment.
  
  
  OBJECTIVE
  To confirm the diagnostic, clinical, and prognostic role of 3D-FLAIR MRI in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).
  
  
  METHODS
  Retrospective study in a tertiary referral center with a consecutive sample of 23 patients diagnosed as having unilateral ISSNHL from January 2010 to March 2011.
  
  
  METHODS
  Patients underwent 3D-FLAIR MRI at 3 T to evaluate ISSNHL, and the MRI images were compared with those belonging to a random group of 20 age-matched healthy patients.
  
  
  METHODS
  Precontrast and postcontrast high-intensity 3D-FLAIR MRI findings in patients with ISSNHL and the correlation with clinical findings.
  
  
  RESULTS
  Thirteen patients showed high-intensity signals in the affected inner ear on precontrast and postcontrast 3D-FLAIR MRI (57%). From the analysis of different MRI sequences, we posited 3 radiologic patterns likely correlated with mild hemorrhage, acute inflammation, and presence or absence of blood-labyrinth or nerve barrier (BLB) breakdown. Hypersignal on 3D-FLAIR MRI was positively associated with pretreatment hearing loss (P = .04) and presence of vertigo (P = .04). A strict correlation also existed between distribution of the signal (vestibule, semicircular canals) and clinical features (vertigo) (P = .04).
  
  
  CONCLUSIONS
  Use of 3D-FLAIR MRI at 3 T may contribute to the elucidation of pathologic conditions in the inner ears of patients with ISSNHL and provide new radiologic indicators (mild hemorrhage, acute inflammation, presence or absence of BLB breakdown) that might assume the role of prognostic factors.
authors.affiliation: Otolaryngology, Audiology, and Phoniatrics Unit, Department of Neuroscience, University of Pisa, Italy. s.berrettini@med.unipi.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Berrettini
authors.forename: Veronica
authors.initials: V
authors.lastname: Seccia
authors.forename: Susanna
authors.initials: S
authors.lastname: Fortunato
authors.forename: Francesca
authors.initials: F
authors.lastname: Forli
authors.forename: Luca
authors.initials: L
authors.lastname: Bruschini
authors.forename: Paolo
authors.initials: P
authors.lastname: Piaggi
authors.forename: Raffaello
authors.initials: R
authors.lastname: Canapicchi
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D003639:Hearing Loss, Sudden / Q000175:diagnosis*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014717:Vertigo / Q000175:diagnosis*; D055815:Young Adult