Comparison between high-resolution 3D-IR with real reconstruction and 3D-flair sequences in the assessment of endolymphatic hydrops in 3 tesla

Background: The main sequences used to assess degree of endolymphatic hydrops (EH) are the 3D- inversion-recovery (IR) with real reconstruction and the 3D- fluid-attenuated inversion recovery (FLAIR).

Objectives: The purpose of this study is to describe and compare both sequences.

Material and methods: Forty-two consecutive patients diagnosed with probable or definite Ménièr´s disease were referred for hydrops MR examination. Vestibular and cochlear EH in both sequences were read by two independent radiologists, unaware of the patient's clinical status. The primary study endpoint was the concordance in the hydrops detection and severity with both imaging sequences. This was assessed using the Cohen's kappa Κ statistic for disease grading and Pearson Χ2 test to test the difference in detection rates of hydrops. Statistical significance was defined as two-sided p < .05.

Results: We obtained an excellent overall concordance, with a kappa of 0.821, (p < .001) when comparing hydrops detection. The degree of concordance is higher in vestibular hydrops than in cochlear hydrops. The 3D-IR sequence detected more hydrops than the 3D FLAIR, (62 vs. 39.5%, p < .03).

Conclusion: The 3D-IR sequence seems to be superior to the 3D-FLAIR for the assessment of EH. Significance: The 3D-IR sequence should be considered as a standalone parameter for a shorter and optimized EH magnetic resonance imaging protocol.

CITATION  Acta Otolaryngol . 2020 Nov;140(11):883-888.
doi: 10.1080/00016489.2020.1792550. Epub 2020 Jul 21.