title: The clinical significance of findings obtained on 3D-FLAIR MR imaging in patients with Ramsay-Hunt syndrome.
abstract: OBJECTIVE
  To investigate the clinical significance of three-dimensional-fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) findings in patients with Ramsay-Hunt syndrome (RHS).
  
  
  METHODS
  Case series.
  
  
  METHODS
  We enrolled 28 consecutive patients of RHS with temporal bone MRI. Initial clinical findings and outcome were assessed by House-Brackmann (HB) scales, electroneuronography (ENoG), and pure tone audiometry (PTA). Two radiologists evaluated the presence of abnormalities on pre-/postcontrast 3D-FLAIR for the cranial nerve (CN)-VII, CN-VIII, inner ear (IE), and the posterior fossa by consensus. The relative signal intensity and enhancement degree (rED) of the structures were measured using ImageJ (http://rsbweb.nih.gov/ij/). Statistical test correlated the clinical symptoms and the outcome with the analysis results of 3D-FLAIR images.
  
  
  RESULTS
  3D-FLAIR demonstrated enhancement of CN-VII in all patients. Precontrast hyperintensity and enhancement were seen in eight and 16 patients with IE, and in four and six with CN-VIII, respectively. Precontrast hyperintensity of IE or CN-VIII was significantly associated with the presence of vertigo (P value < 0.05). Precontrast hyperintensity of IE or CN-VIII significantly correlated with clinical symptoms assessed by HB, ENoG, and PTA (P value < 0.05, respectively). rED of the vestibule moderately correlated with initial HB scale (r = 0.391, P = 0.039). There was no correlation between any of the 3D-FLAIR findings and the follow-up HB.
  
  
  CONCLUSIONS
  RHS shows frequent abnormalities of IE or CN-VIII, as well as CN-VII on pre-/postcontrast 3D-FLAIR images. Precontrast hyperintensity of IE/CN-VIII on 3D-FLAIR is significantly correlated with the severity of facial palsy, the presence of vertigo, and the degree of hearing impairment but not with clinical outcome.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Mi S
authors.initials: MS
authors.lastname: Chung
authors.forename: Jeong H
authors.initials: JH
authors.lastname: Lee
authors.forename: Dae Y
authors.initials: DY
authors.lastname: Kim
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Lim
authors.forename: Joong H
authors.initials: JH
authors.lastname: Ahn
authors.forename: Yu S
authors.initials: YS
authors.lastname: Sung
authors.forename: Young J
authors.initials: YJ
authors.lastname: Choi
authors.forename: Ra G
authors.initials: RG
authors.lastname: Yoon
authors.forename: Jung H
authors.initials: JH
authors.lastname: Baek
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005154:Facial Nerve / Q000473:pathology*; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D016697:Herpes Zoster Oticus / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir
keywords: 3D-FLAIR; MRI; Ramsay-Hunt Syndrome; facial palsy