In vivo imaging of saccular hydrops in humans reflects sensorineural hearing loss rather than Meniere’s disease symptoms
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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.
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.
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 %.
Our results indicate saccular hydrops as a feature of worse than moderate SNHL rather than MD itself.
• 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.
KeywordsInner ear Meniere’s disease Magnetic resonance imaging Endolymphatic hydrops Hearing loss
Endolymphatic sac surgery
Sensorineural hearing loss
Saccule to Utricle Ratio Inversion
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.
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.
Compliance with ethical standards
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.
Written informed consent was obtained from all subjects (patients) in this study.
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).
• case-control study
• performed at one institution
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