Superior vestibular neuritis: improved detection using FLAIR sequence with delayed enhancement (1 h)
- 81 Downloads
Vestibular neuritis is the second cause of vertigo and new imaging protocols using delayed FLAIR with double-dose of gadolinium are proposed for its diagnosis. Our aim is to demonstrate that a single dose of gadolinium is sufficient.
Thirty-three patients with a unilateral vestibular neuritis are compared to a control group. All patients underwent a FLAIR sequence, 1 hour after intravenous injection of a single dose of gadolinium, on a 1.5 Tesla MRI. Two radiologists analyzed the enhancement intensity of the superior (sup VN) and inferior vestibular nerve (inf VN) and ratios to the signal of the cerebellum were calculated (supVN/C). The statistics were performed using Bayesian analysis.
A strong enhancement of the sup VN was observed on the pathological side in 85% of patients with vestibular neuritis. The average signal intensity of the pathological sup VN (139 units ± 44) was more than two times the average intensity in the control group (58.5 units ± 5). The average ratios supVN/C were significantly different between the pathological side in vestibular neuritis (2.43 units ± 0.63) and the control group [1.16 ± 0.14 (Pr(diff > 0) = 1)]. A delayed enhancement > 71.5 units had a sensitivity of 96% and a specificity of 100% for the diagnosis of superior vestibular neuritis.
A delayed FLAIR sequence, acquired 1 hour after a single dose of gadolinium injection, is a useful method for the diagnosis of vestibular neuritis. An enhancement of the sup VN > 71.5 units was in favor of the diagnosis.
KeywordsNeuritis Vestibular neuronitis Magnetic resonance imaging Vestibulocochlear nerve Vertigo
Magnetic resonance imaging
Fluid attenuated inversion recuperation
Benign positional paroxysmal vertigo
Video head impulse test
- Sup VN
Superior vestibular nerve
Inferior vestibular nerve
Ratio of the signal intensity of the superior vestibular nerve to the cerebellum
Ratio of the signal intensity of the inferior vestibular nerve to the cerebellum
No funding was received.
Compliance with ethical standards
Conflict of interest
The authors declare they have no conflict of interest.
- 5.Strupp M, Jäger L, Müller-Lisse U, Arbusow V, Reiser M, Brandt T (1998) High resolution Gd-DTPA MR imaging of the inner ear in 60 patients with idiopathic vestibular neuritis: no evidence for contrast enhancement of the labyrinth or vestibular nerve. J Vestib Res 8:427–433. https://doi.org/10.3233/VES-1998-8603 CrossRefPubMedGoogle Scholar
- 11.Hoff PD (2009) A first course in Bayesian statistical methods, Springer texts in statistics. Springer, New YorkGoogle Scholar
- 12.R Core Team (2016) A language and environment for statistical computing. R Foundation for Statistical Computing, ViennaGoogle Scholar
- 13.Plummer M (2003) JAGS: a program for analysis of bayesian graphical models using gibbs sampling. In: Proceedings of the 3rd international workshop on distributed statistical computing (DSC 2003), Vienna, AustriaGoogle Scholar
- 15.Lim HK, Lee JH, Hyun D et al (2012) MR diagnosis of facial neuritis: diagnostic performance of contrast-enhanced 3D-FLAIR technique compared with contrast-enhanced 3D–T1-fast-field echo with fat suppression. AJNR Am J Neuroradiol 33:779–783. https://doi.org/10.3174/ajnr.A2851 CrossRefPubMedGoogle Scholar