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Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI

The purpose of this study was to prove the hypothesis that caloric response in Ménière's disease (MD) is reduced by hydropic expansion of the vestibular labyrinth, not by vestibular hypofunction, by evaluating the correlation morphologically using an intravenous Gadolinium (IV-Gd) inner ear MRI...

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Autores principales: Choi, Ji Eun, Kim, Yi-Kyung, Cho, Young Sang, Lee, Kieun, Park, Hyun Woo, Yoon, Sung Hoon, Kim, Hyung-Jin, Chung, Won-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708622/
https://www.ncbi.nlm.nih.gov/pubmed/29190293
http://dx.doi.org/10.1371/journal.pone.0188301
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author Choi, Ji Eun
Kim, Yi-Kyung
Cho, Young Sang
Lee, Kieun
Park, Hyun Woo
Yoon, Sung Hoon
Kim, Hyung-Jin
Chung, Won-Ho
author_facet Choi, Ji Eun
Kim, Yi-Kyung
Cho, Young Sang
Lee, Kieun
Park, Hyun Woo
Yoon, Sung Hoon
Kim, Hyung-Jin
Chung, Won-Ho
author_sort Choi, Ji Eun
collection PubMed
description The purpose of this study was to prove the hypothesis that caloric response in Ménière's disease (MD) is reduced by hydropic expansion of the vestibular labyrinth, not by vestibular hypofunction, by evaluating the correlation morphologically using an intravenous Gadolinium (IV-Gd) inner ear MRI. In study I, the prevalence of abnormal video Head Impulse Test (vHIT) results among the patients with definite unilateral MD (n = 24) and vestibular neuritis (VN) (n = 22) were investigated. All patients showed abnormal canal paresis (CP) (> 26%) on caloric tests. The prevalence of abnormal vHIT in patients with abnormal CP was significantly lower in MD patients (12.5%) than that in VN patients (81.8%) (p < 0.001). In study II, morphological correlation between caloric tests and vestibular hydrops level was evaluated in unilateral MD patients (n = 16) who had normal vHIT results. Eleven patients (61%) had abnormal CP. After taking the images of IV-Gd inner ear MRI, the vestibular hydrops ratio (endolymph volume/total lymph volume = %VH) was measured. In addition, the relative vestibular hydrops ratio (%RVH = (%VHaffected ear—%VHunaffected ear) / (%VHaffected ear + %VHunaffected ear)) was calculated. Each ratio (%VH and %RVH) was compared with average peak slow phase velocity (PSPV) and CP, respectively. In the MD patients, %VH of the affected ear correlated significantly with mean PSPV on the same side (rs = -0.569, p = 0.024), while %RVH correlated significantly with CP (rs = 0.602, p = 0.014). In most MD patients (87.5%) compared to VN patients, vHIT results were normal even though the caloric function was reduced. In addition, the reduced caloric function with normal vHIT was related to the severity of the vestibular hydrops measured by the IV-Gd inner ear MRI. These findings concluded that the abnormal caloric tests with normal vHIT in MD indicated severe endolymphatic hydrops rather than vestibular hypofunction.
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spelling pubmed-57086222017-12-15 Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI Choi, Ji Eun Kim, Yi-Kyung Cho, Young Sang Lee, Kieun Park, Hyun Woo Yoon, Sung Hoon Kim, Hyung-Jin Chung, Won-Ho PLoS One Research Article The purpose of this study was to prove the hypothesis that caloric response in Ménière's disease (MD) is reduced by hydropic expansion of the vestibular labyrinth, not by vestibular hypofunction, by evaluating the correlation morphologically using an intravenous Gadolinium (IV-Gd) inner ear MRI. In study I, the prevalence of abnormal video Head Impulse Test (vHIT) results among the patients with definite unilateral MD (n = 24) and vestibular neuritis (VN) (n = 22) were investigated. All patients showed abnormal canal paresis (CP) (> 26%) on caloric tests. The prevalence of abnormal vHIT in patients with abnormal CP was significantly lower in MD patients (12.5%) than that in VN patients (81.8%) (p < 0.001). In study II, morphological correlation between caloric tests and vestibular hydrops level was evaluated in unilateral MD patients (n = 16) who had normal vHIT results. Eleven patients (61%) had abnormal CP. After taking the images of IV-Gd inner ear MRI, the vestibular hydrops ratio (endolymph volume/total lymph volume = %VH) was measured. In addition, the relative vestibular hydrops ratio (%RVH = (%VHaffected ear—%VHunaffected ear) / (%VHaffected ear + %VHunaffected ear)) was calculated. Each ratio (%VH and %RVH) was compared with average peak slow phase velocity (PSPV) and CP, respectively. In the MD patients, %VH of the affected ear correlated significantly with mean PSPV on the same side (rs = -0.569, p = 0.024), while %RVH correlated significantly with CP (rs = 0.602, p = 0.014). In most MD patients (87.5%) compared to VN patients, vHIT results were normal even though the caloric function was reduced. In addition, the reduced caloric function with normal vHIT was related to the severity of the vestibular hydrops measured by the IV-Gd inner ear MRI. These findings concluded that the abnormal caloric tests with normal vHIT in MD indicated severe endolymphatic hydrops rather than vestibular hypofunction. Public Library of Science 2017-11-30 /pmc/articles/PMC5708622/ /pubmed/29190293 http://dx.doi.org/10.1371/journal.pone.0188301 Text en © 2017 Choi et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Choi, Ji Eun
Kim, Yi-Kyung
Cho, Young Sang
Lee, Kieun
Park, Hyun Woo
Yoon, Sung Hoon
Kim, Hyung-Jin
Chung, Won-Ho
Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI
title Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI
title_full Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI
title_fullStr Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI
title_full_unstemmed Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI
title_short Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI
title_sort morphological correlation between caloric tests and vestibular hydrops in ménière's disease using intravenous gd enhanced inner ear mri
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708622/
https://www.ncbi.nlm.nih.gov/pubmed/29190293
http://dx.doi.org/10.1371/journal.pone.0188301
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