New Non-contrast MRI of Endolymphatic Hydrops in Ménière's Disease Considering Inversion Time

Overview

Journal Laryngoscope Investig Otolaryngol

Publisher Wiley

Specialty Otorhinolaryngology

Date 2024 Aug 12

PMID 39130211

Authors

Masanori Ishii

Hiroshi Tanaka

Ryuichi Asai

Yasuhisa Kanai

Yujin Kato

Yusuke Ito

Fumihiro Mochizuki

Masami Yoneyama

Gail Ishiyama

Akira Ishiyama

Affiliations

Soon will be listed here.

Abstract

Objectives: Three-tesla MRI with gadolinium-based contrast agents is important in diagnosing Ménière's disease. However, contrast agents cannot be used in some patients. By using the compositional difference between the inner ear endolymph and perilymph, we performed basic and clinical research focused on potassium ions and protein to find the optimal parameters for visualizing endolymphatic hydrops on MRI without contrast. We then examined the relationship between severity stage and visualization rate of endolymphatic hydrops.

Methods: In phantom experiments simulating the endolymph and perilymph, we explored MRI parameters that could be used to separate endolymph from perilymph by gradually changing the inversion time. We then used these parameters to perform both new non-contrast MRI and contrast MRI on the same day in Ménière's disease patients, and we compared the visualization rates of endolymphatic hydrops under the two modalities. Fifty patients were selected from 478 patients with Ménière's disease of different severity stages; 12 patients had asthma and allergy to contrast agents.

Results: The higher the disease stage, the higher the endolymphatic hydrops visualization rate. The new non-contrast MRI gave significantly higher ( < .01) visualization rates of endolymphatic hydrops on the affected side in patients at Stage 3 or above than in Stages 1 and 2 combined.

Conclusion: New non-contrast MRI with parameters focusing on the endolymph-perilymph difference in the density of protons surrounding the potassium ions and protein can produce images consistent with endolymphatic hydrops. We believe that this groundbreaking method will be useful for diagnosing Ménière's disease in patients.

Evidence Level: Clinical studies are at evidence level 3 in non-randomized controlled trials.

References

Naganawa S, Yamazaki M, Kawai H, Bokura K, Sone M, Nakashima T . Imaging of Ménière's disease after intravenous administration of single-dose gadodiamide: utility of subtraction images with different inversion time. Magn Reson Med Sci. 2012; 11(3):213-9. DOI: 10.2463/mrms.11.213. View

Ishii M, Ishiyama G, Ishiyama A, Kato Y, Mochizuki F, Ito Y . Relationship Between the Onset of Ménière's Disease and Sympathetic Hyperactivity. Front Neurol. 2022; 13:804777. PMC: 8970286. DOI: 10.3389/fneur.2022.804777. View

Naganawa S, Kawai H, Taoka T, Sone M . Improved HYDROPS: Imaging of Endolymphatic Hydrops after Intravenous Administration of Gadolinium. Magn Reson Med Sci. 2017; 16(4):357-361. PMC: 5743528. DOI: 10.2463/mrms.tn.2016-0126. View

HALLPIKE C, Cairns H . Observations on the Pathology of Ménière's Syndrome: (Section of Otology). Proc R Soc Med. 2009; 31(11):1317-36. PMC: 2076781. DOI: 10.1177/003591573803101112. View

Ciuman R . Stria vascularis and vestibular dark cells: characterisation of main structures responsible for inner-ear homeostasis, and their pathophysiological relations. J Laryngol Otol. 2008; 123(2):151-62. DOI: 10.1017/S0022215108002624. View

Brown D, Chihara Y, Wang Y . Changes in utricular function during artificial endolymph injections in guinea pigs. Hear Res. 2013; 304:70-6. DOI: 10.1016/j.heares.2013.05.011. View

Nakashima T, Naganawa S, Pyykko I, Gibson W, Sone M, Nakata S . Grading of endolymphatic hydrops using magnetic resonance imaging. Acta Otolaryngol Suppl. 2009; (560):5-8. DOI: 10.1080/00016480902729827. View

Rauch S, KOSTLIN A . [Chemical aspects of endolymph & perilymph]. Pract Otorhinolaryngol (Basel). 1958; 20(4-5):287-91. View

. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière's disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg. 1995; 113(3):181-5. DOI: 10.1016/S0194-5998(95)70102-8. View

10.

Nakashima T, Naganawa S, Sugiura M, Teranishi M, Sone M, Hayashi H . Visualization of endolymphatic hydrops in patients with Meniere's disease. Laryngoscope. 2007; 117(3):415-20. DOI: 10.1097/MLG.0b013e31802c300c. View

11.

Kumar P, Shen Q, Pivetti C, Lee E, Wu M, Yuan S . Molecular mechanisms of endothelial hyperpermeability: implications in inflammation. Expert Rev Mol Med. 2009; 11:e19. PMC: 2828491. DOI: 10.1017/S1462399409001112. View

12.

Ichinose N, Haraoka K, Mori T, Ozaki M, Taniguchi A . Effect of the Surrounding Magnetic Environment of Temporal Bone on the Fluid Signal Intensity in Human Inner Ear Using a Combined T2 Preparation Pulse and Fluid Attenuated Inversion Pulse Technique. Magn Reson Med Sci. 2023; 24(1):35-45. PMC: 11733505. DOI: 10.2463/mrms.mp.2023-0074. View

13.

Iwasaki S, Shojaku H, Murofushi T, Seo T, Kitahara T, Origasa H . Diagnostic and therapeutic strategies for Meniere's disease of the Japan Society for Equilibrium Research. Auris Nasus Larynx. 2020; 48(1):15-22. DOI: 10.1016/j.anl.2020.10.009. View

14.

Salt A, DeMott J . Longitudinal endolymph flow associated with acute volume increase in the guinea pig cochlea. Hear Res. 1997; 107(1-2):29-40. DOI: 10.1016/s0378-5955(97)00018-x. View

15.

Konishi T, Hamrick P, Walsh P . Ion transport in guinea pig cochlea. I. Potassium and sodium transport. Acta Otolaryngol. 1978; 86(1-2):22-34. DOI: 10.3109/00016487809124717. View

16.

Kato Y, Naganawa S, Taoka T, Yoshida T, Sone M . Pitfalls of Using T2-contrast Enhancement Techniques in 3D-FLAIR to Detect Endolymphatic Hydrops. Magn Reson Med Sci. 2022; 22(3):335-344. PMC: 10449551. DOI: 10.2463/mrms.mp.2022-0017. View

17.

Bydder G, Young I . MR imaging: clinical use of the inversion recovery sequence. J Comput Assist Tomogr. 1985; 9(4):659-75. View

18.

Lopez-Escamez J, Carey J, Chung W, Goebel J, Magnusson M, Mandala M . Diagnostic criteria for Menière's disease. J Vestib Res. 2015; 25(1):1-7. DOI: 10.3233/VES-150549. View

19.

Yoshida T, Naganawa S, Kobayashi M, Sugimoto S, Katayama N, Nakashima T . O-labeled water distribution in the human inner ear: Insights into lymphatic dynamics and vestibular function. Front Neurol. 2022; 13:1016577. PMC: 9668890. DOI: 10.3389/fneur.2022.1016577. View

20.

Naganawa S, Nakashima T . Visualization of endolymphatic hydrops with MR imaging in patients with Ménière's disease and related pathologies: current status of its methods and clinical significance. Jpn J Radiol. 2014; 32(4):191-204. DOI: 10.1007/s11604-014-0290-4. View