Givi Lengvenis 1,3, Aiste Paskoniene 2,4, Renata Baltagalviene 1,3, Egle Visinskaite 1,3, Vetra Markeviciute 4, Arturas Samuilis 1,3, Eugenijus Lesinskas 2,4, Jurate Dementaviciene 1,3
1 Centre of Radiology and Nuclear medicine, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
2 Centre of Ear, Nose and Throat, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
3 Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Lithuania
4 Clinic of Ear, Nose, Throat and Eye diseases, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Lithuania
Background and Aims: Endolymphatic hydrops (EH) can be detected in vivo by means of MR imaging in patients with Ménière’s disease (MD). The majority of studies on EH were performed using 3T MRI systems, although in everyday practice these systems may not be readily available, especially in low-resource settings. The aim of our study was to determine the ability of 1.5T MRI system to detect endolymphatic hydrops in clinically suspected MD patients group by comparing the results with those of 3T MRI system.
Methods: A total of 38 patients with clinical MD suspicion who were referred to Vilnius University Hospital Santaros Klinikos during 2017–2018 period were prospectively included in the study. All patients underwent 3T MR imaging 4 to 6 hours after a double dose of IV gadobutrol injection. Within a short period of waiting time, each patient was additionally imaged on a 1.5T MRI system. Two radiologists (one experienced neuroradiologist and one radiologist in training) reviewed images separately and in case of disagreement, a consensus was reached by discussion. Images from 1.5T and 3T systems were presented for review separately in random order. Radiologists were blinded to patients’ clinical data. Only vestibular endolymphatic structures were assessed and all the inner ears were classified as either having enlarged or normal endolymphatic sacs.
Results: EH was found in 11 (28.9%) patients based on 3T images. Of these, unilateral EH was observed in 9 (81.8%) cases, bilateral in 2 (18.2%) – a total of 13 of 76 inner ears had EH. On 1.5T images, 11 inner ears were correctly diagnosed as having EH, 2 inner ears had false negative results, 1 was incorrectly diagnosed as having EH and 62 were true negatives. The sensitivity of 1.5T MRI compared to 3T was thus 84.62% (95% CI: 54.55-98.08%), specificity 98.41% (95% CI: 91.47-99.96%), positive predictive value 91.67% (95% CI: 60.82-98.73%) and negative predictive value 96.88% (95% CI: 89.65-99.11%) in this clinically suspected MD patients group.
Conclusion: Our results suggest that 1.5T MRI has acceptable sensitivity and specificity compared to 3T system in detecting vestibular endolymphatic hydrops in patients with clinically suspected Ménière’s disease. Further studies are needed to determine the possible role of 1.5T MRI for EH investigations.