title: Recurrent peripheral vestibulopathy: Is MRI useful for the diagnosis of endolymphatic hydrops in clinical practice?
abstract: OBJECTIVE
  Recurrent peripheral vestibulopathy (RPV) is a public health problem, yet the aetiology remains unclear. Recent developments in MRI of endolymphatic hydrops (EH) allow for a better understanding of inner ear disorders. We intended to study the prevalence of EH in patients with RPV, in comparison to those with Meniere's disease (MD).
  
  
  METHODS
  MRI examinations were performed 4 hours after intravenous injection of gadoteric acid in 132 patients with RPV (n = 64) and MD (n = 68). Two radiologists retrospectively studied the prevalence and localization of EH in RPV and MD groups. Patients were graded based on the number and localization of hydrops, between 1 (EH in either cochlea or vestibule on one side) and 4 (EH in cochlea and vestibule on both ears).
  
  
  RESULTS
  We identified EH in 31 out of 64 patients and in 61 out of 68 patients in the RPV and MD groups, respectively. There was a significant difference regarding the number of subjects with EH between the two groups (p ≤ 0.01), with a higher average number of hydrops localization in MD group (p ≤ 0.01).
  
  
  CONCLUSIONS
  MRI may reveal EH in some cases among patients with RPV, suggesting a similar pathophysiological mechanism in comparison with MD.
  
  
  CONCLUSIONS
  • MRI may reveal endolymphatic hydrops in some patients with recurrent peripheral vestibulopathy. • We suggest a similar pathophysiological mechanism in recurrent vestibulopathy and Meniere's Disease. • MRI with delayed acquisition helps clinicians to assess patients with recurrent vestibulopathy. • The outcome would be to aid the development of adapted therapeutic strategies. • MRI of endolymphatic hydrops should probably be included in future diagnostic protocols.
authors.affiliation: Department of Neuroradiology and MRI, University Hospital of Grenoble, IFR1, Grenoble, France, aattye@chu-grenoble.fr.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Attyé
authors.forename: G
authors.initials: G
authors.lastname: Dumas
authors.forename: I
authors.initials: I
authors.lastname: Troprès
authors.forename: M
authors.initials: M
authors.lastname: Roustit
authors.forename: A
authors.initials: A
authors.lastname: Karkas
authors.forename: E
authors.initials: E
authors.lastname: Banciu
authors.forename: J
authors.initials: J
authors.lastname: Pietras
authors.forename: L
authors.initials: L
authors.lastname: Lamalle
authors.forename: S
authors.initials: S
authors.lastname: Schmerber
authors.forename: A
authors.initials: A
authors.lastname: Krainik
mesh_terms: D003051:Cochlea; D003287:Contrast Media; D003937:Diagnosis, Differential; D018159:Endolymphatic Hydrops / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis; D008875:Middle Aged; D015588:Observer Variation; D010808:Physical Examination; D012008:Recurrence; D012189:Retrospective Studies; D015837:Vestibular Diseases / Q000175:diagnosis*
chemical_list: D003287:Contrast Media
references.citation: Otol Neurotol. 2013 Sep;34(7):1241-6
references.pmid: 23921924
references.citation: Acta Otolaryngol. 2013 Feb;133(2):123-9
references.pmid: 23106485
references.citation: Magn Reson Med Sci. 2013 Mar 25;12(1):63-8
references.pmid: 23474961
references.citation: Eur J Radiol. 2012 May;81(5):885-90
references.pmid: 21555197
references.citation: Magn Reson Med Sci. 2012;11(1):43-51
references.pmid: 22450386
references.citation: Acta Otolaryngol Suppl. 2009 Feb;(560):5-8
references.pmid: 19221900
references.citation: Eur Radiol. 2015 Feb;25(2):585-95
references.pmid: 25319347
references.citation: AJNR Am J Neuroradiol. 2014 Dec;35(12):E9
references.pmid: 25234035
references.citation: Neuroradiology. 2011 Dec;53(12):1009-15
references.pmid: 21221556
references.citation: Laryngoscope. 2005 Aug;115(8):1454-7
references.pmid: 16094123
references.citation: Laryngoscope. 2012 Apr;122(4):883-6
references.pmid: 22374685
references.citation: Acta Otolaryngol. 2013 Oct;133(10):1040-6
references.pmid: 24032569
references.citation: Magn Reson Med Sci. 2012;11(4):303-9
references.pmid: 23269018
references.citation: Otol Neurotol. 2014 Jun;35(5):880-3
references.pmid: 24770407
references.citation: Acta Otolaryngol. 2011 Mar;131(3):247-57
references.pmid: 21070090
references.citation: Lancet. 2008 Aug 2;372(9636):406-14
references.pmid: 18675691
references.citation: Otol Neurotol. 2005 Jan;26(1):74-81
references.pmid: 15699723
references.citation: AJNR Am J Neuroradiol. 2014 Dec;35(12):2366-70
references.pmid: 25034778
references.citation: AJNR Am J Neuroradiol. 2012 Apr;33(4):773-8
references.pmid: 22173762
references.citation: Radiology. 1990 Feb;174(2):395-400
references.pmid: 2404313
references.citation: Ann Otol Rhinol Laryngol. 1989 Nov;98(11):873-83
references.pmid: 2817679
references.citation: Otolaryngol Clin North Am. 2002 Jun;35(3):547-64
references.pmid: 12486839
references.citation: Acta Otolaryngol. 2012 Mar;132(3):234-40
references.pmid: 22201445
references.citation: AJNR Am J Neuroradiol. 2008 Apr;29(4):724-6
references.pmid: 18184846
references.citation: Otolaryngol Head Neck Surg. 2004 Jan;130(1):113-9
references.pmid: 14726919
references.citation: Otol Neurotol. 2007 Feb;28(2):145-51
references.pmid: 17255880
references.citation: AJNR Am J Neuroradiol. 2012 Jan;33(1):104-9
references.pmid: 22158921
references.citation: Magn Reson Med Sci. 2014;13(2):73-80
references.pmid: 24769637
references.citation: Korean J Radiol. 2008 May-Jun;9(3):212-8
references.pmid: 18525223
references.citation: Laryngoscope. 1981 Jan;91(1):1-6
references.pmid: 6969834
references.citation: Otolaryngol Clin North Am. 2002 Jun;35(3):529-45, vi
references.pmid: 12486838
references.citation: AJNR Am J Neuroradiol. 2014 Jul;35(7):1387-92
references.pmid: 24524921
references.citation: Laryngoscope. 2009 Nov;119(11):2216-20
references.pmid: 19806642
references.citation: BMJ Open. 2013 Feb 14;3(2):null
references.pmid: 23418296
references.citation: Laryngoscope. 2004 Aug;114(8):1373-6
references.pmid: 15280710
references.citation: Magn Reson Med Sci. 2015;14(1):77-83
references.pmid: 25500782
references.citation: Laryngoscope. 1993 Mar;103(3):277-85
references.pmid: 8441315
references.citation: Acta Otolaryngol. 2014 Jul;134(7):666-71
references.pmid: 24847946