Trans-tympanum and intravenous administration of contrast agents 3D-FLAIR MR inner ear imaging in patients with Meniere's disease / 中国医学影像技术

ABSTRACT

Objective: To observe the changes of inner ear in patients with Meniere's disease with 3D-FLAIR MRI after intratympanic (IT) gadolinium injection or intravenous (IV) gadolinium injection. Methods: Totally 36 patients with Meniere's disease were randomly divided into 2 groups. Eighteen of them underwent intravenous injection of GD-BOPTA (IV group), while the rest 18 underwent bilateral IT injection of equivalent dilution of GD-DTPA (IT group). 3D-FLAIR MR examinations were performed after 4 and 24 hours, respectively. ROIs in cochlear perilymph and medulla oblongata were drawn on MRI, and signal-intensity ratio (CM ratio) was subsequently evaluated and compared with paired t test. In addition, the ratio of endolymphatic hydrops (EH) of each group were separately observed and analyzed using chi-squared test. Results: For IT group, comparable CM ratios were found between the affected and unaffected sides of perilymph regions (1.86±0.74 vs 1.68±0.77,n=18,P=0.805). For IV group, significant difference of CM ratios was observed between the affected and unaffected sides of perilymph regions (1.46±0.31 vs 1.26±0.21, n=18, P=0.001). Meanwhile, significantly higher CM ratio was shown in affected sides of perilymph in IT group than that in IV group (1.86±0.74 vs 1.46±0.31,n=18, P=0.044), and significantly higher CM ratio was found in unaffected sides of perilymph in IT group than that in IV group (1.68±0.77 vs 1.26±0.21, n=18, P=0.032). Conclusion: Trans-tympanum administration and intravenous administration inner ear MRI show the same effect, and the former has higher signal intensity, while bilateral inner ear and blood-labyrinth barrier permeability could be observed using the latter with less injury.