MRI of endolymphatic hydrops in patients with vestibular schwannomas: a case-controlled study using non-enhanced T2-weighted images at 3 Teslas

  • Aurélie Karch-Georges
  • Francis Veillon
  • Hella Vuong
  • Dominique Rohmer
  • Anne Karol
  • Anne Charpiot
  • Nicolas Meyer
  • Aina VenkatasamyEmail author



Vestibular schwannomas (VS) may present with similar symptoms endolymphatic hydrops. Association between hydrops and internal auditory canal VS has been described by Naganawa et al. (Neuroradiology 53:1009–1015, 2011), but has never been confirmed since. The aim of this work was to study the prevalence of a saccular dilation on a T2-weighted sequence at 3 T MRI in VS compared to a control group.

Materials and methods

All patients presenting with typical VS between May 2009 and July 2018 were included (n = 183) and compared to a control group (n = 53). All underwent a high-resolution T2-weighted 3D sequence (FIESTA-C). The height and width of the saccule were measured on a coronal plane by two radiologists.


The saccule was dilated on the side of the schwannoma in 28% of the cases (p = 2.81 × 10− 5), with 15.7% of bilateral dilation. Saccular dilation was correlated to sensorineural hearing loss (OR 3.26, p = 0.02). There was also a significant correlation between saccular hydrops on the normal contralateral side of patients with VS and vertigo (p = 0.049), and between saccular hydrops on the side of the tumour and tinnitus (p = 0.006).


A third (29%) of VS are associated with a saccular dilation on the side of the tumour, which is an MR sign of endolymphatic hydrops (bilateral in 15.7% of the cases) and it appears related to sensorineural hearing loss and tinnitus, as well as vertigo if a contralateral dilation is present. This opens new therapeutic potentialities with the use of anti-vertiginous drugs, which could have a beneficial effect on the clinical symptoms.


Magnetic resonance imaging (MRI) Endolymphatic hydrops Sensorineural hearing loss Vertigo Neuroma Acoustic 


Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Service de Radiologie 1Hôpitaux Universitaires de Strasbourg, Hôpital de HautepierreStrasbourg CEDEXFrance
  2. 2.Service de chirurgie ORLHôpitaux Universitaires de StrasbourgStrasbourg CEDEXFrance
  3. 3.Département de StatistiquesHôpitaux Universitaires de StrasbourgStrasbourgFrance
  4. 4.Laboratory Stress Response and Innovative Therapies “Streinth”Université de Strasbourg, Inserm IRFAC UMR_S1113StrasbourgFrance

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