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The vestibular aqueduct ossification on temporal bone CT: an old sign revisited to rule out the presence of endolymphatic hydrops in Menière’s disease patients

European Radiology volume 30, pages 6331–6338 (2020)Cite this article

Abstract

Objectives

Menière’s disease (MD) is associated with endolymphatic hydrops (EH), which is an accumulation of excessive endolymphatic fluid in the inner ear. However, using temporal bone CT, lower visualization rates of the vestibular aqueduct (VA) in these patients have also been reported.

Methods

In this retrospective single-center imaging study, we have included 25 healthy subjects and 47 patients having a definite, probable, or possible clinical diagnosis of MD that underwent temporal bone CT and inner ear MRI performed 4 h after contrast media administration. Two radiologists independently ranked the morphology of the VA in healthy subjects and in MD patients, using a three-level score (completely visible, discontinuous, and not visible). Each subject was then graded, based on both the VA’s appearance and on EH presence.

Results

In healthy subjects, the VA was normal (grade 0) in 22/25 (88%) ears and discontinuous (grade I) in 3 healthy ears (12%). In the symptomatic ears of MD patients, we found 17/56 ears (30.3%) with VA grade 0, 15/56 ears (26.8%) with grade I, and 24/56 ears (42.8%) with grade II (p < 0.001). In MD patients, EH was observed in 46/94 ears (48.9%). A VA of grade 0 would eliminate the presence of EH with a negative predictive value of 88.6%, while a VA grade II would predict the presence of saccular hydrops with a positive predictive value of 93.1%.

Conclusion

The evaluation by temporal bone CT of the VA can predict the presence of EH on MRI with a high positive predictive value.

Key Points

• The evaluation by temporal bone CT of the vestibular aqueduct can predict the presence of EH on MRI.

• A vestibular aqueduct of grade 0 would eliminate the presence of EH on MRI with a negative predictive value of 88.6%.

• A vestibular aqueduct grade II would predict the presence of endolymphatic hydrops on MRI with a positive predictive value of 93.1%.

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Abbreviations

CT:

Computed tomography

EH:

Endolymphatic hydrops

MD:

Menière’s disease

MRI:

Magnetic resonance imaging

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Acknowledgments

We thank Pamela Haylock (Lariboisiere University Hospital) for critically editing the manuscript.

Funding

The authors state that this work has not received any funding.

Author information

Affiliations

  1. Neuroradiology Unit, Department of Neuroradiology, Lariboisière University Hospital, 75010, Paris, France

    Jeanne Mainnemarre, Jean-Pierre Guichard, Emmanuel Houdart, Arnaud Attyé & Michael Eliezer

  2. Department of Head and Neck Surgery, Lariboisière University Hospital, Paris, France

    Charlotte Hautefort

  3. Centre d’Explorations Fonctionnelles Otoneurologiques, Paris, France

    Michel Toupet

  4. Grenoble Alpes University, Grenoble, France

    Arnaud Attyé

Authors
  1. Jeanne Mainnemarre
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  2. Charlotte Hautefort
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  3. Michel Toupet
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  4. Jean-Pierre Guichard
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  5. Emmanuel Houdart
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  6. Arnaud Attyé
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  7. Michael Eliezer
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Corresponding author

Correspondence to Michael Eliezer.

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The scientific guarantor of this publication is Michael Eliezer.

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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 has significant statistical expertise.

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Written informed consent was waived by the Institutional Review Board.

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Methodology

• retrospective

• case-control study

• performed at one institution

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Mainnemarre, J., Hautefort, C., Toupet, M. et al. The vestibular aqueduct ossification on temporal bone CT: an old sign revisited to rule out the presence of endolymphatic hydrops in Menière’s disease patients. Eur Radiol 30, 6331–6338 (2020). https://doi.org/10.1007/s00330-020-06980-w

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  • DOI: https://doi.org/10.1007/s00330-020-06980-w

Keywords

  • Inner ear
  • Menière’s disease
  • Magnetic resonance imaging (MRI)
  • Endolymphatic hydrops (EH)
  • Vestibular aqueduct