Department of Neuroradiology, Lariboisière University Hospital, 75010, Paris, France.
Siemens Healthcare France, Saint-Denis, France.
Eur Radiol. 2022 Oct;32(10):6900-6909. doi: 10.1007/s00330-022-08889-y. Epub 2022 Jun 27.
The aim of this study was to shorten the 4-h delay between the intravenous administration of gadolinium and MRI acquisition for hydrops evaluation using an optimized 3D-FLAIR sequence in patients with Menière's disease.
This was a single-center prospective study including 29 patients (58 ears), recruited between November 2020 and February 2021. All patients underwent a 3-T MRI with an optimized 3D-FLAIR sequence without contrast then at 1 h, 2 h, and 4 h after intravenous administration of gadobutrol. The signal intensity ratio was quantitatively assessed with the region of interest method. We also evaluated the volume of endolymphatic structures (saccule, utricle) then the presence of endolymphatic hydrops and blood-labyrinthine barrier impairment at each acquisition time.
For all ears, the signal intensity ratio was significantly non-inferior at 2 h compared to 4 h, with a mean geometric signal intensity ratio at 0.83 (95% CI: 0.76 to 0.90, one-sided p < .001 for non-inferiority at -30% margin). Mean volume equivalence of saccule and utricle between 2 and 4 h was proven at a ± 0.20 standardized deviation equivalence margin. Intra-rater agreements (Cohen's kappa) were all greater than 0.90 for all endolymphatic hydrops location and blood-labyrinthine-barrier impairment between the 2- and 4-h assessments.
We demonstrated that using an optimized 3D-FLAIR sequence we could shorten the acquisition from 4 to 2 h with a high reliability for the diagnosis of endolymphatic hydrops and blood-labyrinthine-barrier impairment.
Clinical trial no: 38RC15.173 KEY POINTS: • Magnetic resonance imaging with delayed 3D-FLAIR sequences allows the diagnosis of endolymphatic hydrops in patients with definite Menière's disease. • An optimized 3D-FLAIR sequence with a long TR of 16000 ms and a constant flip angle allows for reducing the delay between intravenous injection of gadobutrol and MRI acquisition from 4 to 2 h to diagnose endolymphatic hydrops. • Reducing this delay between intravenous injection and MRI acquisition could have implications for clinical practice for both patients and imaging departments.
本研究旨在通过在梅尼埃病患者中使用优化的 3D-FLAIR 序列，将静脉注射钆对比剂后至磁共振成像（MRI）采集之间的 4 小时延迟缩短，以评估积水。
这是一项单中心前瞻性研究，纳入了 2020 年 11 月至 2021 年 2 月期间招募的 29 例（58 耳）患者。所有患者均接受了 3T MRI 检查，采用优化的 3D-FLAIR 序列，无需对比剂，然后在静脉注射钆布醇后 1 小时、2 小时和 4 小时进行 MRI 检查。采用感兴趣区法对信号强度比进行定量评估。我们还评估了内淋巴结构（球囊、椭圆囊）的体积，然后在每个采集时间评估内淋巴积水和血迷路屏障损伤的存在情况。
对于所有耳，2 小时的信号强度比与 4 小时相比具有显著非劣效性，几何平均信号强度比为 0.83（95%置信区间：0.76 至 0.90，单侧 p<.001，负 30%边际非劣效性）。2 小时和 4 小时之间球囊和椭圆囊的平均容量等效性在±0.20 标准化偏差等效范围内。2 小时和 4 小时评估之间，所有内淋巴积水位置和血迷路屏障损伤的内观察者一致性（Cohen's kappa）均大于 0.90。
我们证明，使用优化的 3D-FLAIR 序列，我们可以将采集时间从 4 小时缩短至 2 小时，对于内淋巴积水和血迷路屏障损伤的诊断具有高度可靠性。
38RC15.173
延迟的 3D-FLAIR 序列磁共振成像可诊断明确的梅尼埃病患者的内淋巴积水。
采用长重复时间（TR）为 16000 毫秒且恒定翻转角的优化 3D-FLAIR 序列，可将静脉注射钆对比剂与 MRI 采集之间的延迟从 4 小时缩短至 2 小时，以诊断内淋巴积水。
缩短静脉注射与 MRI 采集之间的延迟可能会对患者和影像科都有临床意义。
