Imaging diagnostic value of 1-hour delayed Gadolinium-DTPA enhanced three-dimensional (3D) T1 SPACE magnetic resonance images (MRI) in Ramsay Hunt syndrome.

AIM: This study aimed to evaluate the diagnostic value of 1-hour gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced three-dimensional (3D) T1-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) magnetic resonance images (MRI) in Ramsay Hunt syndrome (RHS).

MATERIALS AND METHODS: Patients diagnosed with RHS between January 2021 and January 2023 were retrospectively enrolled. Routine and 1-hour-delayed gadolinium-DTPA-enhanced 3D T1 SPACE MR images were retrospectively analysed. Signal-intensity ratios of the facial nerve to that of the adenohypophysis were calculated.

RESULTS: The degree of enhancement of the affected segments of the facial nerve on 1-hour-delayed contrast-enhanced magnetic resonance imaging (MRI) was significantly higher than that on routine contrast-enhanced MRI. Enhancement of the distal facial nerve segments, vestibulocochlear nerve, and cochlea was also observed. Meanwhile, in patients with concurrent meningitis, we observed marked enhancement of the cisternal segment of the facial nerve. The signal-intensity ratio on the affected side was higher than that on the unaffected side in the labyrinthian and geniculate ganglion segments on both routine and 1-hour-delayed contrast-enhanced MRI. Additionally, the signal-intensity ratios of the affected labyrinthine and geniculate ganglion segments were higher on 1-hour-delayed contrast-enhanced MRI than on routine contrast-enhanced MRI.

CONCLUSION: Compared with routine contrast-enhanced MRI, 1-hour-delayed contrast-enhanced MRI provides improved visualisation of facial nerve enhancement. Our findings suggest that 1-hour-delayed contrast-enhanced MRI may facilitate the detection of imaging findings associated with early central nervous system (CNS) involvement in patients with RHS complicated by meningitis.