Department of Neuroradiology and MR Unit, Lariboisière University Hospital, 75010, Paris, France.
Department of Head and Neck Surgery, Lariboisiere University Hospital, Paris, France.
Eur Arch Otorhinolaryngol. 2020 May;277(5):1305-1314. doi: 10.1007/s00405-020-05829-8. Epub 2020 Feb 8.
Bilateral vestibulopathy (BV) is an uncommon disorder and the etiology remained idiopathic in most cases. Delayed 3D-FLAIR sequences have provided new insights into various inner ear diseases, allowing the evaluation of the endolymphatic space and the permeability of the blood-labyrinthine barrier (BLB). The aim of this study was to assess both the morphology of the endolymphatic space and the permeability of the BLB in patients with BV as evaluated by delayed 3D-FLAIR sequences.
In this retrospective study, we performed 3D-FLAIR sequences 4 h after administering contrast media to 42 patients with BV. Two radiologists independently evaluated the morphology of the endolymphatic space (either vestibular atelectasis or endolymphatic hydrops) and the permeability of the BLB.
Morphologic anomalies of the endolymphatic space and vestibular blood-labyrinthine barrier impairment were observed in 59.6% of patients with BV. Bilateral vestibular atelectasis (VA) was found in 21 patients (50%), involving only the utricle and all three ampullas while the saccule was always observed with no sign of collapse: idiopathic BV (n = 19), aminoglycoside administration (n = 1) and few days following abdominal surgery (n = 1). One patient had bilateral vestibular malformation. BLB impairment was observed in five patients (11.9%): paraneoplastic (n = 1), lymphoma (n = 1), autoimmune (n = 1), and vestibular "neuritis" (n = 2). Seventeen patients (40.4%) had normal MRI with no endolymphatic space anomaly or BLB impairment.
Patients with BV presented with morphologic anomalies of the endolymphatic space or BLB impairment in 59.6% of patients.
双侧前庭病（BV）是一种不常见的疾病，大多数情况下其病因仍为特发性。延迟 3D-FLAIR 序列为各种内耳疾病提供了新的见解，使人们能够评估内淋巴间隙和血迷路屏障（BLB）的通透性。本研究旨在通过延迟 3D-FLAIR 序列评估 BV 患者的内淋巴间隙形态和 BLB 的通透性。
在这项回顾性研究中，我们对 42 例 BV 患者在给予对比剂后 4 小时进行了 3D-FLAIR 序列检查。两位放射科医生独立评估内淋巴间隙（前庭萎陷或内淋巴积水）的形态和 BLB 的通透性。
59.6%的 BV 患者存在内淋巴间隙形态异常和 BLB 通透性损害。21 例（50%）患者出现双侧前庭萎陷（VA），仅累及椭圆囊和所有三个壶腹，而球囊始终未见塌陷：特发性 BV（n=19）、氨基糖苷类药物治疗（n=1）和腹部手术后数天（n=1）。1 例患者存在双侧前庭发育不良。5 例（11.9%）患者存在 BLB 损害：副肿瘤（n=1）、淋巴瘤（n=1）、自身免疫性（n=1）和前庭“神经炎”（n=2）。17 例（40.4%）患者 MRI 正常，无内淋巴间隙异常或 BLB 损害。
BV 患者中 59.6%存在内淋巴间隙形态异常或 BLB 损害。
