MRI diagnosis of saccular hydrops: Comparison of heavily-T2 FIESTA-C and 3D-FLAIR sequences with delayed acquisition.

ABSTRACT

PURPOSE: Currently, 3D-FLAIR sequence performed 4hours after the intravenous administration of a single dose of contrast media is the imaging technique of choice for the diagnosis of saccular hydrops (SH). Recently, the diagnosis of SH has also been reported with heavily-T2 weighted sequences. MATERIALS AND METHODS: In this retrospective imaging study, we performed 3D-FLAIR sequences 4hours after contrast media administration and 3D FIESTA-C sequences before and 4hours after contrast media administration in 30 patients with unilateral definite, probable or possible clinical diagnosis of Menière's disease (MD). Two radiologists, blinded to the clinical data, independently assessed the presence of saccular hydrops. Inter-reader agreement tests were performed. RESULTS: On delayed post-contrast 3D-FLAIR sequence, 15 patients out of 30 referred with a SH that was never seen on the controlateral asymptomatic side. The specificity and the sensitivity to detect MD side were 100% and 50% respectively. On non-enhanced 3D FIESTA-C sequence, 16 patients out of 30 (53%) referred with a saccular hydrops that was observed in 6 patients on the clinical asymptomatic ear. The specificity and the sensitivity to detect MD side were 80% and 33% respectively. On delayed 3D FIESTA-C sequence, 13 patients out of 30 (43%) referred with a saccular hydrops that was seen in 4 patients on the controlateral asymptomatic side. The specificity and the sensitivity to detect MD side were 83% and 27% respectively. CONCLUSION: Delayed post-contrast 3D-FLAIR is highly specific of MD symptoms while 3D FIESTA-C sequences are less sensitive and specific for the diagnosis of SH.