Comparison of contrast effect on the cochlear perilymph after intratympanic and intravenous gadolinium injection

AJNR Am J Neuroradiol. 2012 Apr;33(4):773-8. doi: 10.3174/ajnr.A2821. Epub 2011 Dec 15.

Abstract

Background and purpose: 3D-FLAIR imaging 24 hours after intratympanic gadolinium injection (IT-method) or 4 hours after IV injection (IV-method) has been used to visualize the endolymphatic hydrops in Ménière disease. The purpose of this study was to compare the degree of perilymph enhancement with the 2 methods and the perilymph contrast-effect difference with the IV-method in both sides in patients with unilateral Ménière disease.

Materials and methods: Sixty-one patients with Ménière disease or sudden SNHL were included in this study. Thirty-nine patients who underwent the unilateral IT-method (Gd-DTPA was diluted 8-fold with saline) and 22 patients who underwent the IV-method (a double-dose of Gd-HP-DO3A; 0.4 mL/kg body weight [ie, 0.2 mmol/kg body weight]) at 3T were analyzed retrospectively. Regions of interest of the cochlear perilymph and the medulla oblongata were determined on each image, and the signal-intensity ratio between the 2 (CM ratio) was subsequently evaluated. The differences in the CM ratio between the 2 methods (Student t test) and the IV-method CM ratio between the affected and unaffected sides in patients with unilateral Ménière disease (paired t test) were evaluated.

Results: The IT-method CM ratio (2.98 ± 1.15, n = 39) was higher than the IV-method CM ratio (1.61 ± 0.60, n = 44; P < .001). In patients with unilateral Ménière disease who underwent the IV-method (n = 9), the CM ratio of the affected side (1.86 ± 0.74) was higher than that of the unaffected side (1.29 ± 0.31, P < .05).

Conclusions: In general, the IT-method provides higher perilymph enhancement than the IV-method. In the patients with unilateral Ménière disease who underwent the IV-method, the affected side had a higher contrast effect.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cochlea / pathology
  • Contrast Media / administration & dosage
  • Female
  • Gadolinium DTPA / administration & dosage*
  • Humans
  • Image Enhancement / methods*
  • Injections, Intralesional
  • Injections, Intravenous
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meniere Disease / pathology*
  • Middle Aged
  • Perilymph / cytology*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tympanic Membrane / pathology*
  • Young Adult

Substances

  • Contrast Media
  • Gadolinium DTPA