Visualization of the saccule and utricle with non-contrast-enhanced FLAIR sequences.
Eur Radiol. 2021-12-20; 32(5): 3532-3540
DOI: 10.1007/s00330-021-08403-w
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1. Eur Radiol. 2022 May;32(5):3532-3540. doi: 10.1007/s00330-021-08403-w. Epub
2021 Dec 20.
Visualization of the saccule and utricle with non-contrast-enhanced FLAIR
sequences.
Fukutomi H(#)(1), Hamitouche L(#)(2), Yamamoto T(1), Denat L(1), Zhang L(3),
Zhang B(4), Prevost V(5), Triaire B(5), Dousset V(1)(2)(6), Barreau X(2),
Tourdias T(7)(8)(9).
Author information:
(1)Univ. Bordeaux, Institut de Bio-imagerie IBIO, 33000, Bordeaux, France.
(2)CHU de Bordeaux, Neuroimagerie Diagnostique Et Thérapeutique, 33000,
Bordeaux, France.
(3)Canon Medical Systems China, Beijing, China.
(4)Canon Medical Systems Europe, Zoetermeer, The Netherlands.
(5)Canon Medical Systems Corporation, Tochigi, Japan.
(6)Univ. Bordeaux, INSERM, Neurocentre Magendie, 146 rue Léo saignat,
U1215F-3300, Bordeaux Cedex, France.
(7)Univ. Bordeaux, Institut de Bio-imagerie IBIO, 33000, Bordeaux, France.
.
(8)CHU de Bordeaux, Neuroimagerie Diagnostique Et Thérapeutique, 33000,
Bordeaux, France. .
(9)Univ. Bordeaux, INSERM, Neurocentre Magendie, 146 rue Léo saignat,
U1215F-3300, Bordeaux Cedex, France. .
(#)Contributed equally
OBJECTIVES: 3D-fluid attenuation inversion recovery (FLAIR) collected 4 h after
intravenous gadolinium injection can delineate the perilymphatic space (PLS)
from the endolymphatic space (ELS) to capture endolymphatic hydrops, the
pathological counterpart of Ménière’s disease. We aimed to optimize
visualization of such inner ear internal anatomy using 3D-FLAIR without
injection.
METHODS: 3D-FLAIR signal from different fluid compartments such as PLS and ELS
was first simulated. Then, twenty-two healthy subjects were scanned at 3.0-T MRI
with non-injected 3D-FLAIR using variable T2 preparations (T2Preps) (OFF, 200,
400, and 600 ms) and variable inversion times (TIs) (from 224 to 5000 ms) and
different resolutions (1.0 × 1.0 × 1.5, 0.6 × 0.6 × 0.8, and 0.6 × 0.6 × 0.6
mm3). The relative contrast between PLS and ELS and the visibility of the
saccule and utricle were assessed. Additionally, non-injected 3D-FLAIR with the
optimal setting was tested in a Ménière patient and compared with
gadolinium-injected 3D-FLAIR.
RESULTS: The PLS and ELS were differentiated when T2Prep was used but not
without. The relative contrast was larger with T2Prep at 400 ms than at 200 or
600 ms (0.72 ± 0.22 vs. 0.44 ± 0.11, p = 0.019; and 0.72 ± 0.22 vs. 0.46 ± 0.28,
p = 0.034, respectively). The saccule and utricle were best delineated in 87. %
cases with T2Prep = 400 and TI = 2100 ms at the highest resolution.
Visualization of the saccule and utricle in the optimized non-injected 3D-FLAIR
was similar to conventional injected 3D-FLAIR in a patient.
CONCLUSIONS: Combining a specific T2Prep and TI in non-injected 3D-FLAIR could
separate PLS and ELS and even the saccule and utricle, paving the way toward
future application to diagnose Ménière’s disease.
KEY POINTS: • MRI can capture the internal anatomy of inner ear without
injection of contrast media. • Specific parameters consisting of a T2
preparation of 400 ms and an inversion time of 2100 ms must be used to visualize
the saccule and utricle on non-injected 3D-FLAIR.
© 2021. The Author(s), under exclusive licence to European Society of Radiology.
DOI: 10.1007/s00330-021-08403-w
PMID: 34928414 [Indexed for MEDLINE]