Evidence for bilateral endolymphatic hydrops in ipsilateral delayed endolymphatic hydrops: preliminary results from examination of five cases.

CONCLUSION

After the administration of a standard dose of gadodiamide, an intravenous gadolinium-based contrast agent (GBCA), magnetic resonance imaging (MRI) evaluation of endolymphatic hydrops (EH) became possible in patients with ipsilateral delayed endolymphatic hydrops (DEH). We found that patients with ipsilateral DEH may also have bilateral EH.

OBJECTIVE

MRI evaluation contributes to understanding of the pathological conditions in patients with EH. However, double or triple the standard dose of GBCA is often required to obtain images of high quality. We attempted to examine EH bilaterally in patients with ipsilateral DEH after routine administration of an intravenous GBCA.

METHODS

GBCA (gadodiamide, 0.2 ml/kg) was administered intravenously to five patients with ipsilateral DEH. Three-dimensional fluid attenuated inversion recovery (3D-FLAIR) MRI was performed with a 3-T MRI scanner 4 h after GBCA administration.

RESULTS

In all five patients, EH was observed in the affected vestibules. Moreover, EH was observed bilaterally in four (80%) of five patients with ipsilateral DEH. The region of the deaf ear affected by EH was considerably larger compared with the normal ear in three patients. However, observed regions of EH were of approximately the same size in both ears in patients 4 and 5.