Open AccessInner ear enhancement on gadolinium-enhanced 3D FLAIR images in a patient with Vogt–Koyanagi–Harada disease
Author(s) -
Kazutoshi Hida,
Koichi Takano,
Kengo Yoshimitsu,
Jiro Fukae,
Koichi Hokao
Publication year - 2017
Publication title -
bjr case reports
Language(s) - English
Resource type - Journals
ISSN - 2055-7159
DOI - 10.1259/bjrcr.20160090
Subject(s) - vogt–koyanagi–harada disease , medicine , fluid attenuated inversion recovery , leptomeninges , choroid , tinnitus , pathology , sarcoidosis , ophthalmology , fundus (uterus) , uveitis , radiology , central nervous system , magnetic resonance imaging , retina , audiology , physics , optics
Vogt–Koyanagi–Harada (VKH) disease is an autoimmune disorder that occurs in the melanocytes present in the uvea, leptomeninges, skin and inner ear. Clinically, this disease is characterized by bilateral uveitis and retinal detachment and is associated with meningismus and hearing loss. Gadolinium (Gd)-enhanced MRI may aid in demonstrating bilateral choroidal thickening and central nervous system involvement. We present a case of VKH where Gd-enhanced three-dimensional (3D) fluid attenuation inversion recovery (FLAIR) imaging showed abnormal bilateral enhancement in the inner ears. A 36-year-old female was referred to our institution with symptoms of visual disturbance, headache and tinnitus, and was diagnosed with VKH based on fundus examination and clinical presentations. MRI findings revealed bilateral enhancement in the choroid, leptomeninges, and inner ears. In particular, Gd-enhanced 3D FLAIR showed more conspicuous enhancement of the leptomeninges and inner ear compared with Gd-enhanced 3D T 1 weighted image. Therefore, Gd-enhanced 3D FLAIR imaging can be used when leptomeningeal or inner ear pathology is clinically suspected.