فهرست نشریات علمی دسترسی آزاد ایران

Background: There is no gold standard diagnostic test for endolymphatic hydrops (EH). Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging has been reported to depict EH with administration of gadolinium-based contrast media (GBCM). However, the optimal scan interval and angulation remain unknown in 3D-FLAIR labyrinthine imaging following double-dose injections of a gadolinium-based contrast agent in patients with vertigo and sensorineural hearing loss. Objectives: This study aimed to determine the optimal parameters of 3D-FLAIR labyrinthine imaging, including the optimal scan angulation and scan interval, for patients with sensorineural hearing loss and vertigo. Results: The 3D-FLAIR images showed the strongest image contrast in the cochlea with a double-dose gadolinium-based contrast injection at six hours post-injection. Significantly higher SIR and CNR values were reported at six hours post-injection in both unaffected and affected ears compared to other intervals (4 h vs. 6 h in the affected side, SIR: 1.65 ± 0.24 vs. 2.09 ± 0.47, CNR: 13.88 ± 5.54 vs. 19.17 ± 6.81; in the unaffected side, SIR: 1.58 ± 0.27 vs. 1.82 ± 0.34, CNR: 12.20 ± 3.88 vs. 15.42 ± 4.58, P < 0.001 for all; 6 h vs. 8 h in the affected side: SIR: 2.09 ± 0.47 vs. 1.72 ± 0.43, CNR: 19.17 ± 6.81 vs. 12.22 ± 4.96; in the unaffected side, SIR: 1.82 ± 0.34 vs. 1.57 ± 0.30, CNR: 15.42 ± 4.58 vs. 10.61 ± 3.87, P < 0.001 for all). Visualization of the endo- and perilymphatic spaces for both the cochlea and vestibule was significantly better at six hours post-injection compared to four hours post-injection in both affected sides (P < 0.05 for both). The optimal angulation ranged from 6.20° to 13.6° (P < 0.001). Conclusion: By using an optimal scan interval, together with an optimal scan angulation, 3D-FLAIR imaging can reliably visualize the endolymphatic space and sensitively indicate cochlear blood-labyrinth barrier disruptions without requiring extra image reconstruction.