Isolated enhancement of the superior semi-circular canal on inner ear MRI: acute vestibular syndrome or superior semi-ci
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Isolated enhancement of the superior semi‑circular canal on inner ear MRI: acute vestibular syndrome or superior semi‑circular canal dehiscence? Michael Eliezer1 · Michel Toupet2 · Jean‑Pierre Guichard1 · Emmanuel Houdart1 · Charlotte Hautefort3 Received: 23 March 2020 / Accepted: 13 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Recently, it has been reported that patients with acute vestibular syndrome (AVS) could present a marked enhancement of the semi-circular canals, involving mostly the superior semi-circular canals on delayed inner ear MRI. Methods We reported one patient having AVS and another one having superior semi-circular canal dehiscence syndrome (SCDS) who underwent delayed inner ear MRI performed 4 h after contrast media administration. Results On delayed inner ear MRI, a marked enhancement of the superior semi-circular canal was observed in both patients. Although the clinical presentation is clearly not the same, the co-existence between these two disorders is possible. For this reason, in patients with AVS, the presence of a marked enhancement of the superior semi-circular canal should rule out the presence of a co-existing SCDS on temporal bone CT, particularly if the patient reported cochlear symptoms such as pulsatile tinnitus and/or autophony. Conclusion To our knowledge, this is the first report showing this finding on delayed inner ear MRI in a patient with SCDS. In AVS patients, this radiological anomaly could be particularly disturbing and should rule out the presence of a co-existing SCDS. Keywords Inner ear · MRI · 3D-FLAIR · Acute vestibular syndrome · Superior semi-circular syndrome dehiscence
Introduction Over the last decade, delayed inner ear MRI became the imaging technic of choice in clinical practice in patients with Menière’s disease [1, 2]. Indeed, based on the selective enhancement of the perilymphatic space 4 h after the intravenous administration of contrast media, it enables to assess the endolymphatic space, which was not possible on routine inner ear MRI. Since the first study of Naganawa et al. in 2006, most research teams have performed this protocol to detect the presence of endolymphatic hydrops. However, * Michael Eliezer [email protected] 1
Department of Neuroradiology, Lariboisière University Hospital, 75010 Paris, France
2
Centre d’Explorations Fonctionnelles Otoneurologiques, Paris, France
3
Department of Head and Neck Surgery, Lariboisère University Hospital, Paris, France
delayed inner ear MRI can also evaluate slight impairment of the permeability of the blood–labyrinth barrier in other inner ear disorders, which was also not highlighted by routine inner ear MRI [3–5]. Here, we reported two patients having two different inner ear disorders that showed the same anomaly on MRI: a marked enhancement of the superior semi-circular canal on delayed inner ear MRI. It has been demonstrated that patients with acute vestibular syndrome (AVS) also known as vestibular “neuritis” c
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