To investigate the role of magnetic resonance imaging (MRI) in the diagnosis of sudden sensorineural hearing loss (SSNHL).
Fifty-four consecutive patients affected by SSNHL were investigated using brain MRI. MRI was performed with an eight-channel phased-array head coil to study the entire audiovestibular pathway and the whole brain. The protocol study consisted of a high-resolution study of the temporal bone, internal auditory canal (IAC), cerebellopontine angle (CPA), and brainstem combining 2 mm thin-slice axial T(2)-weighted two-dimensional fast spin echo (FSE) and fluid-attenuated inversion recovery (FLAIR) sequences, pre- and postcontrast (gadolinium-diethylenetriamine pentaacetic acid) administration fat-suppressed axial T(1)-weighted two-dimensional FSE sequences, and a T(2)*-weighted three-dimensional Fourier transformation-constructive interference in steady state sequence (FT-CISS) , with 0.4 mm ultrathin partitions. The rest of the brain was studied with a 4 mm axial T(2)-weighted FLAIR sequence.
Thirty-one of 54 (57%) cases of SSNHL presented with MRI abnormalities. In 6 of 54 cases, the detected abnormality was directly correlated to the clinical picture (2 labyrinthine hemorrhage, 1 cochlear inflammation, 1 acoustic neuroma, 1 arachnoid cyst of the CPA, and 1 case of white matter lesions in the pons, compatible with demyelinating plaques along the central audiovestibular nervous pathway, as the first expression of multiple sclerosis).
An extensive MRI study of the audiovestibular nervous pathway and of the whole brain, pre- and postparamagnetic contrast administration, is recommended to rule out the wide spectrum of abnormalities that can cause SSNHL.
[Show abstract][Hide abstract] ABSTRACT: Imaging of the temporal bone is under continous developement. In the recent decades the technical advances of magnetic resonance imaging and computed tomography have contributed to improved imaging quality in assessment of the temporal bone. Dedicated imaging protocols have been developed and are routinely employed in most institutions. However, imaging interpretation remains challenging, since the temporal bone is an anatomically highly complex region and most diseases of the inner ear occur with low incidence, so that even radiologists experienced in the field may be confronted with such entities for the first time. The current review gives an overview about symptoms and imaging appearance of malformations and acquired lesion of the inner ear.
European Radiology 03/2008; 18(2):319-30. DOI:10.1007/s00330-007-0759-y · 4.01 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 3D-FLAIR imaging is sensitive to inflammatory inner ear disturbances and may be a useful method in investigating the severity of inner ear disturbance in cases of inflammation-induced SNHL.
To evaluate the usefulness of the three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) sequence in investigating different etiology of inner ear disturbances in cases with inflammation-induced acute sensorineural hearing loss (SNHL).
Five cases with inflammation-induced acute SNHL by different conditions are included in this study: acute meningitis, acute otitis media, and Wegener granulomatosis. Imaging analysis was performed using a three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) sequence, and correlation between clinical symptoms and FLAIR abnormalities was evaluated.
In the affected ears in all cases, 3D-FLAIR revealed high pre-contrast signal and increased signal in the cochlea after the administration of gadolinium. Enhancement was still observed in the inner ear after several months with continuing nystagmus in those cases induced by meningitis and severe otitis media. In a case with Wegener granulomatosis, increased signal in the post-contrast images was stronger on the side of the cochlea with the worse hearing level.
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