Open AccessPresent and future of the labyrinth imaging: Focus on the use of T2-weighted and contrast-enhanced delayed FLAIR (1 h) sequences
Author(s) -
F. Veillon,
S. Riehm,
Michaël Eliezer,
Aurélie Karch-Georges,
Anne Charpiot,
Aude Fleury,
Idir Djennaoui,
P. Hémar,
Philippe Schultz,
Christian Debry,
Aïna Venkatasamy
Publication year - 2021
Publication title -
journal of vestibular research
Language(s) - English
Resource type - Journals
eISSN - 1878-6464
pISSN - 0957-4271
DOI - 10.3233/ves-200796
Subject(s) - fluid attenuated inversion recovery , saccule , membranous labyrinth , medicine , contrast (vision) , inner ear , vestibular system , utricle , magnetic resonance imaging , t2 weighted , semicircular canal , anatomy , nuclear medicine , radiology , artificial intelligence , computer science
OBJECTIVE: Part of the recent progress in the labyrinth imaging has been made possible by the rise of contrast-free T2-weighted and delayed (1h) FLAIR sequences. The aim of this article is to review evidence for the use of these two sequences to image the inner ear, especially the posterior membranous labyrinth. MATERIAL AND METHODS: We analyzed MRI-based papers (2007–2020)using high-resolution T2-weighted or contrast-enhanced FLAIR (1h) sequences to image the inner ear. RESULTS: T2-weighted sequences (3T MRI)enabled the visualization of the posterior membranous labyrinth with good correlation when compared to corresponding histological slices.Significant progress has been made, especially in terms of scanning time, aiming at reducing it, in order to decrease motions artifacts. The saccule is visible on a 3T MRI without significant motion artifacts. Its shape is ovoid, with a maximum height and width of 1.6 and 1.4 mm, respectively. An enlarged saccule was observed in 84%of patients with unilateral Meniere’s disease, in 28%of patients with vestibular schwannomas (VS) and 47%of patients with intralabyrinthine schwannomas. VS obstructing the internal auditory canal caused a decrease of the perilymphatic signal (more moderate decrease in meningiomas) on T2 gradient-echo images. Contrast-enhanced FLAIR sequences are useful to image vestibular/facial neuritis and inflammatory inner ear diseases. CONCLUSION: Precise analysis of the posterior membranous labyrinth, in terms of size, shape and signal intensity, is possible on a 3T MRI using high-resolution gradient-echo T2-weighted sequences. Such sequences are an interesting add-on to delayed (4h30) FLAIR-based protocols for labyrinth imaging.