TY - JOUR T1 - Comparison of Contrast Effect on the Cochlear Perilymph after Intratympanic and Intravenous Gadolinium Injection JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. DO - 10.3174/ajnr.A2821 AU - M. Yamazaki AU - S. Naganawa AU - M. Tagaya AU - H. Kawai AU - M. Ikeda AU - M. Sone AU - M. Teranishi AU - H. Suzuki AU - T. Nakashima Y1 - 2011/12/15 UR - http://www.ajnr.org/content/early/2011/12/15/ajnr.A2821.abstract N2 - 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. Abbreviations CMcochlea/medulla oblongataGd-DTPAgadolinium-diethylene-triamine pentaacetic acidGd-HP-DO3AgadoteridolITintratympanicr1T1 relaxivitySNHLsensorineural hearing lossCWMcerebellar white matter/medulla oblongata ER -