The vestibular aqueduct sign: Magnetic resonance imaging can detect abnormalities in both ears of patients with unilateral Meniere's disease

Abstract : Background and purpose In patients with Meniere's disease (MD), saccular hydrops can only be studied by magnetic resonance imaging (MRI) at a late stage when the disease is already responsible for moderate to severe hearing loss. However, these patients may also present vestibular aqueduct (VA) abnormalities. Materials and methods In this prospective study (38RC14.428 for healthy subjects/38RC15.173 for patients), imaging was carried out on a 3T MRI scanner. Twenty healthy subjects (13 women, median age 53.5 [52.2–66.7]) and twenty MD patients (9 women, median age 54.5 [52–66.7]) had MRI scans with 3D-FLAIR sequences without injection, then 4 hours after a single intra-venous dose of contrast agent. Two radiologists independently ranked the morphology of the VA in the healthy subjects and in MD patients, using a three-level score (completely visible, discontinuous and not visible). Each subject was then graded, based on both the VA's appearance and on saccular hydrops presence. Inter-reader agreement tests were performed. Results In controls and patients, VA modifications were symmetrical without significant difference between the symptomatic and asymptomatic ears. The presence of at least one ear with discontinuous VA showed a correlation with clinical MD (P < 0.001) with a sensitivity of 90%. Ten patients had saccular hydrops, but only in the symptomatic ears. The evaluation of VA did not differ between MRI, both within MRI series or between the two radiologists (kappa without and with contrast agent = 0.9 and 0.92 respectively). Conclusion Analysis of the vestibular aqueduct by MRI detects abnormalities in both ears of patients with unilateral MD.
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Submitted on : Tuesday, February 19, 2019 - 3:13:51 PM
Last modification on : Thursday, April 4, 2019 - 1:16:23 AM

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Arnaud Attye, Marion Barma, Sébastien Schmerber, Georges Dumas, Michael Eliezer, et al.. The vestibular aqueduct sign: Magnetic resonance imaging can detect abnormalities in both ears of patients with unilateral Meniere's disease. Journal de Neuroradiologie / Journal of Neuroradiology, Elsevier Masson, 2018, ⟨10.1016/j.neurad.2018.10.003⟩. ⟨hal-02025088⟩

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