Journal article
Retrolabyrinthine Bone Thickness as a Radiologic Marker for the Hypoplastic Endotype in Meniere Disease
American journal of neuroradiology : AJNR, Vol.45(9), pp.1363-1369
09/2024
DOI: 10.3174/ajnr.A8339
PMCID: PMC11392355
PMID: 39054294
Abstract
BACKGROUND AND PURPOSE: Meniere disease (MD) manifests in 2 major endotypes: one with a hypoplastic, underdeveloped endolymphatic sac (MD-hp) and the other with a normally developed sac that degenerates over time (MD-dg). Determining the specific endotype in patients is important for predicting disease progression, tailoring patient counseling, and optimizing treatment strategies. Endotype diagnosis involves measuring an angular trajectory of the vestibular aqueduct (ATVA), with an ATVA >= 140 degrees indicative of MD-hp and an ATVA <= 120 degrees of MD-dg. However, assessing the ATVA can be challenging. This study aimed to explore the link between ATVA and the thickness of the retrolabyrinthine bone as an alternative diagnostic measure that could provide differentiation between MD endotypes using CT and MR imaging. MATERIALS AND METHODS: Retrospective review of CT temporal bone imaging from 32 adult patients with definite MD (60 ears) and 33 age-matched controls without MD or other inner ear symptoms (61 ears) was performed. The ATVA and retrolabyrinthine bone thickness were measured using uniform methodology on standardized axial CT images. Comparative analyses were performed to determine the correlation between ATVA and retrolabyrinthine bone thickness. Additionally, from a separate cohort of 11 patients (22 ears), CT and MR examinations of the temporal bone were retrospectively reviewed for retrolabyrinthine bone thickness measurements, to verify the correlation across the 2 modalities. RESULTS: The average retrolabyrinthine bone thickness was statistically significantly different between MD endotypes, being a mean of 0.8 (SD, 0.3) mm in patients with MD-hp (ATVA >= 140 degrees) and 2.0 (SD, 0.9) mm in patients with MD-dg (ATVA <= 120 degrees), with a consistent pattern of thin retrolabyrinthine bone in MD-hp and variable thickness in MD-dg. Receiver operating characteristic curve analysis within the MD cohort revealed that a retrolabyrinthine bone thickness >= 1.2 mm effectively rules out MD-hp. Excellent interrater reliability was noted for the retrolabyrinthine measurement, and there was near-perfect correlation between CT and MR measurements. CONCLUSIONS: Retrolabyrinthine bone thickness proved to be a useful and straightforward alternative marker for distinguishing MD endotypes, being particularly useful for excluding MD-hp. Including information on retrolabyrinthine bone thickness should be considered a routine part of reporting in the context of MD imaging.
Details
- Title: Subtitle
- Retrolabyrinthine Bone Thickness as a Radiologic Marker for the Hypoplastic Endotype in Meniere Disease
- Creators
- Amy F. Juliano - Massachusetts Eye and Ear InfirmaryKuei-You Lin - Shin Kong WHS Memorial HospitalNitesh Shekhrajka - University of Iowa Hospitals and ClinicsDonghoon Shin - Massachusetts General HospitalSteven D. Rauch - Massachusetts Eye and Ear InfirmaryAndreas H. Eckhard - Massachusetts Eye and Ear Infirmary
- Resource Type
- Journal article
- Publication Details
- American journal of neuroradiology : AJNR, Vol.45(9), pp.1363-1369
- DOI
- 10.3174/ajnr.A8339
- PMID
- 39054294
- PMCID
- PMC11392355
- NLM abbreviation
- AJNR Am J Neuroradiol
- ISSN
- 0195-6108
- eISSN
- 1936-959X
- Publisher
- Amer Soc Neuroradiology
- Number of pages
- 7
- Grant note
- MOST 111-2221-E-341-001-MY3 / National Science and Technology Council, Taiwan
- Language
- English
- Electronic publication date
- 07/25/2024
- Date published
- 09/2024
- Academic Unit
- Radiology
- Record Identifier
- 9984700438002771
Metrics
9 Record Views