The diagnosis of “definite” Méniére's disease (MD) relies upon its clinical manifestations. MD has been related with Endolymphatic Hydrops (EH), an enlargement of the endolymphatic spaces (ES) (cochlear duct, posterior labyrinth, or both). Recent advances in Magnetic Resonance (MR) imaging justify its increasing role in the diagnostic workup: EH can be consistently recognized in living human subjects by means of 3-dimensional Fluid-Attenuated Inversion-Recovery sequences (3D-FLAIR) acquired 4 h post-injection of intra-venous (i.v.) Gadolinium-based contrast medium, or 24 h after an intratympanic (i.t.) injection. Different criteria to assess EH include: the comparison of the area of the vestibular ES with the whole vestibule on an axial section; the saccule-to-utricle ratio (“SURI”); and the bulging of the vestibular organs toward the inferior 1/3 of the vestibule, in contact with the stapedial platina (“VESCO”). An absolute link between MD and EH has been questioned, since not all patients with hydrops manifest MD symptoms. In this literature review, we report the technical refinements of the imaging methods proposed with either i.t. or i.v. delivery routes, and we browse the outcomes of MR imaging of the ES in both MD and non-MD patients. Finally, we summarize the following imaging findings observed by different researchers: blood-labyrinthine-barrier (BLB) breakdown, the extent and grading of EH, its correlation with clinical symptoms, otoneurological tests, and stage and progression of the disease.

Advanced Imaging of the Vestibular Endolymphatic Space in Ménière's Disease / D. Zanetti, G. Conte, E. Scola, S. Casale, G. Lilli, F. Di Berardino. - In: FRONTIERS IN SURGERY. - ISSN 2296-875X. - 8(2021), pp. 700271.1-700271.9. [10.3389/fsurg.2021.700271]

Advanced Imaging of the Vestibular Endolymphatic Space in Ménière's Disease

G. Conte
Secondo
;
F. Di Berardino
Ultimo
2021

Abstract

The diagnosis of “definite” Méniére's disease (MD) relies upon its clinical manifestations. MD has been related with Endolymphatic Hydrops (EH), an enlargement of the endolymphatic spaces (ES) (cochlear duct, posterior labyrinth, or both). Recent advances in Magnetic Resonance (MR) imaging justify its increasing role in the diagnostic workup: EH can be consistently recognized in living human subjects by means of 3-dimensional Fluid-Attenuated Inversion-Recovery sequences (3D-FLAIR) acquired 4 h post-injection of intra-venous (i.v.) Gadolinium-based contrast medium, or 24 h after an intratympanic (i.t.) injection. Different criteria to assess EH include: the comparison of the area of the vestibular ES with the whole vestibule on an axial section; the saccule-to-utricle ratio (“SURI”); and the bulging of the vestibular organs toward the inferior 1/3 of the vestibule, in contact with the stapedial platina (“VESCO”). An absolute link between MD and EH has been questioned, since not all patients with hydrops manifest MD symptoms. In this literature review, we report the technical refinements of the imaging methods proposed with either i.t. or i.v. delivery routes, and we browse the outcomes of MR imaging of the ES in both MD and non-MD patients. Finally, we summarize the following imaging findings observed by different researchers: blood-labyrinthine-barrier (BLB) breakdown, the extent and grading of EH, its correlation with clinical symptoms, otoneurological tests, and stage and progression of the disease.
ear; hydrops; magnetic resonance imaging; membranous labyrinth; vestibule
Settore MED/32 - Audiologia
Settore MED/31 - Otorinolaringoiatria
Settore MED/37 - Neuroradiologia
Article (author)
File in questo prodotto:
File Dimensione Formato  
95. Imaging in frontiers in surgery.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 268.69 kB
Formato Adobe PDF
268.69 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/891106
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 2
social impact