WS 43 - Advanced MR Imaging Of Inner Ear (Hydrops Protocol): How to Explore Cochleovestibular Disorders in 2023?
March 3, 10:00 - 11:00 CET
Dizziness, hearing loss and tinnitus are common symptoms that may require an MRI scan. For many years, this exam has been considered as a screening tool for rare diseases such as vestibular schwannoma, multiple sclerosis, ischemic events of the posterior fossa. MRI using IAC protocol failed to diagnose the most frequent conditions leading to these symptoms and was therefore frequently normal. For example, Meniere’s disesase, vestibular neuritis, and labyrinthitis usually doesn’t display abnormalities in any of the sequences done in the IAC protocol (normal T2 signal, no T1 enhancement, very mild to none FLAIR abnormalities). Over the last decade, advances in MRI have led to the development of new sequences that allow detailed analysis of the inner ear components, particularly the membranous labyrinth (endolymphatic sector). Those new MRI acquisitions use a high-resolution dedicated inversion-recovery sequences, with delayed acquisition (2 to 4 hours) from a gadolinium injection and deep-learning reconstructions in order to obtain a high contrast between endolymphatic and perilymphatic compartments. These technical advances, correlated with those of vestibular functional explorations performed in otoneurology, have generated a new dynamic in the understanding and management of cochleovestibular disorders, as shown by the increasing number of scientific publications on this topic. This presentation is intended to make you an actor in the radiological transition towards new MRI protocols for clinical conditions (acute and/or chronic cochlear and/or vestibular syndromes) whose exploration has too long been limited.