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In vivo imaging of saccular hydrops in humans reflects sensorineural hearing loss rather than Meniere’s disease symptoms

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A Head and Neck to this article was published on 30 April 2018

Abstract

Objectives

A case-controlled imaging study demonstrated that saccular hydrops was specific to Meniere’s disease (MD), but only present in a subset of patients. Here, we compared patients with definite MD, vertigo and sensorineural hearing loss (SNHL) to elucidate the relationship between saccular hydrops and extent of SNHL.

Methods

In this prospective study, we performed 3D-FLAIR sequences between 4.5 and 5.5 h after contrast media injection in patients with MD (n=20), SNHL (n=20), vertigo (n=20) and 30 healthy subjects. Two radiologists independently graded saccular hydrops. ROC analysis was performed to determine the hearing loss threshold to differentiate patients with saccular hydrops.

Results

Saccular hydrops was found in 11 of 20 MD patients, 10 of 20 SNHL patients and in none of the vertigo patients and healthy subjects. In SNHL patients, 45 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 90 %. In MD patients, 40 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 44 %.

Conclusions

Our results indicate saccular hydrops as a feature of worse than moderate SNHL rather than MD itself.

Key Points

• MRI helps clinicians to assess patients with isolated low-tone sensorineural hearing loss.

• Saccular hydrops correlates with sensorineural hearing loss at levels above 40 dB.

• Vertigo patients without sensorineural hearing loss do not have saccular hydrops.

• Saccular hydrops is described in patients without clinical diagnosis of Meniere’s disease.

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Abbreviations

ESS:

Endolymphatic sac surgery

MD:

Meniere’s disease

SNHL:

Sensorineural hearing loss

SURI:

Saccule to Utricle Ratio Inversion

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Acknowledgements

The authors acknowledge the valuable assistance of Patrice Jousse and Hélène Fournié for their work in editing the MRI pictures and drawings. We also thank Dr Alison Foote (Grenoble Alps University Hospital) for critically reviewing the manuscript.

Funding

IRMaGe MRI/Neurophysiology facility was partly funded by the French program “Investissement d’Avenir” run by the “Agence Nationale pour la Recherche”; grant “Infrastructure d’avenir en Biologie Santé” - ANR-11-INBS-0006. This study was also partly funded by Guerbet SA for MRI in healthy volunteers.

Author information

Author notes

  1. Alexandre Krainik and Sébastien Schmerber contributed equally to this manuscript as last authors

Authors and Affiliations

  1. Department of Neuroradiology and MRI, Grenoble Alpes University Hospital – SFR RMN Neurosciences, Grenoble, France

    Arnaud Attyé & Alexandre Krainik

  2. IRMaGe, University Grenoble Alpes, F-38000, Grenoble, France

    Arnaud Attyé & Alexandre Krainik

  3. Neuroradiology and MR Unit, CS 10217- Grenoble University Hospital, F-38043, Grenoble cedex 9, France

    Arnaud Attyé

  4. Department of Radiology, Rouen University Hospital, Rouen, France

    Michael Eliezer

  5. Unité innovation technologique, Centre d’Investigation Clinique, CHU de Grenoble, CS 10217, 38043, Grenoble cedex 9, France

    Maud Medici & Irène Tropres

  6. IRMaGe, Inserm US 17, CNRS UMS 3552, Grenoble, France

    Irène Tropres

  7. Department of Otology, Grenoble Alpes University Hospital, Grenoble, France

    Georges Dumas & Sébastien Schmerber

Authors
  1. Arnaud Attyé
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  2. Michael Eliezer
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  3. Maud Medici
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  4. Irène Tropres
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  5. Georges Dumas
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  6. Alexandre Krainik
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  7. Sébastien Schmerber
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Corresponding author

Correspondence to Arnaud Attyé.

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Guarantor

The scientific guarantor of this publication is Arnaud Attyé.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Maud Medici) has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study healthy subjects have been previously reported in European Radiology (https://www.ncbi.nlm.nih.gov/pubmed/27999985).

Methodology

• prospective

• case-control study

• performed at one institution

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Attyé, A., Eliezer, M., Medici, M. et al. In vivo imaging of saccular hydrops in humans reflects sensorineural hearing loss rather than Meniere’s disease symptoms . Eur Radiol 28, 2916–2922 (2018). https://doi.org/10.1007/s00330-017-5260-7

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  • DOI: https://doi.org/10.1007/s00330-017-5260-7

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