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European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 12, pp 3309–3316 | Cite as

Superior vestibular neuritis: improved detection using FLAIR sequence with delayed enhancement (1 h)

  • Aina VenkatasamyEmail author
  • Tri Thai Huynh
  • Nathan Wohlhuter
  • Hella Vuong
  • Dominique Rohmer
  • Anne Charpiot
  • Nicolas Meyer
  • Francis Veillon
Otology
  • 81 Downloads

Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Neuritis Vestibular neuronitis Magnetic resonance imaging Vestibulocochlear nerve Vertigo 

Abbreviations

MRI

Magnetic resonance imaging

FLAIR

Fluid attenuated inversion recuperation

BPPV

Benign positional paroxysmal vertigo

VHIT

Video head impulse test

Sup VN

Superior vestibular nerve

InfVN

Inferior vestibular nerve

SupVN/C

Ratio of the signal intensity of the superior vestibular nerve to the cerebellum

InfVN/C

Ratio of the signal intensity of the inferior vestibular nerve to the cerebellum

Notes

Funding

No funding was received.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Aina Venkatasamy
    • 1
    • 2
    Email author
  • Tri Thai Huynh
    • 1
  • Nathan Wohlhuter
    • 3
  • Hella Vuong
    • 3
  • Dominique Rohmer
    • 3
  • Anne Charpiot
    • 3
  • Nicolas Meyer
    • 4
  • Francis Veillon
    • 1
  1. 1.Service de radiologie 1, Hôpital de HautepierreHôpitaux Universitaires de StrasbourgStrasbourgFrance
  2. 2.Laboratory Stress Response and Innovative Therapies “Streinth”Université de Strasbourg, Inserm IRFAC UMR_S1113StrasbourgFrance
  3. 3.Service de Chirurgie ORL, Hôpital de HautepierreHôpitaux Universitaires de StrasbourgStrasbourgFrance
  4. 4.Département de StatistiquesHôpitaux Universitaires de StrasbourgStrasbourgFrance

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