T2 relaxation time shortening in the cochlea of patients with sudden sensory neuronal hearing loss: a retrospective study using quantitative synthetic magnetic resonance imaging

Abstract

Objectives

High cochlear signal intensity on three-dimensional (3D) T2 fluid-attenuated inversion recovery (FLAIR) sequences in patients with sudden sensorineural hearing loss (SSNHL) has been reported. Here, we evaluated the cochlear T2 relaxation time differences in patients with idiopathic SSNHL using quantitative synthetic MRI (SyMRI).

Methods

Twenty-four patients with unilateral SSNHL who underwent precontrast conventional 3D FLAIR and SyMRI were retrospectively included. T1 and T2 relaxation times and the proton density (PD) of the bilateral ears were measured by manually drawn regions of interest. Wilcoxon signed-rank tests and intra- and interobserver correlation analyses were performed. Qualitative analysis was also performed to determine the presence and laterality of the asymmetric high signal intensity on synthetic FLAIR (SyFLAIR) images.

Results

The T2 relaxation time was significantly lower in the affected (basal and apico-middle turns) than in the unaffected cochlea (basal turn: 519 ± 181.3 vs. 608.8 ± 203.6, p = 0.042; apico-middle turn: 410.8 ± 163.8 vs. 514.5 ± 186.3, p = 0.037). There were no significant differences in the T1 relaxation time and PD between the affected and unaffected ears (p > 0.05). Additionally, three patients without asymmetric signal intensity on conventional MRI showed asymmetric increased signal intensity in the affected ear on SyFLAIR.

Conclusions

The T2 relaxation time was significantly shorter in the affected than in the unaffected cochlea of patients with idiopathic SSNHL. The SyMRI-derived T2 relaxation time may be a promising imaging marker, suggesting that the changes in inner ear fluid composition are implicated in the idiopathic SSNHL development.

Key Points

• T2 relaxation time was significantly lower in the affected than in the unaffected cochlea.

• SyFLAIR showed increased lesion conspicuity compared to conventional 3D-FLAIR in detecting asymmetric high signal intensity of the affected side.

• SyMRI-derived T2 relaxation time may be a promising imaging marker of the affected ear in patients with idiopathic SSNHL.

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Abbreviations

CPMG:

Carr-Purcell-Meiboom-Gill

FLAIR:

Fluid-attenuated inversion recovery

FOV:

Field of view

ICC:

Intraclass correlation coefficient

MDME:

Multi-dynamic multi-echo

PD:

Proton density

PTA:

Pure-tone audiometry

ROI:

Region of interest

SSNHL:

Sudden sensorineural hearing loss

SyFLAIR:

Synthetic FLAIR

SyMRI:

Synthetic MRI

TE:

Echo time

TI:

Inversion time

TR:

Repetition time

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Acknowledgements

This work was supported by the 2019 Inje University research grant.

Funding

This work was supported by the 2019 Inje University research grant.

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Correspondence to Yeonah Kang.

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Guarantor

The scientific guarantor of this publication is Yeonah Kang.

Conflict of interest

The authors of this manuscript declare relationships with the company GE Healthcare. Joonsung Lee is an employee of GE Healthcare.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

The requirement for written informed consent was waived by the Institutional Review Board of Heaundae Paik Inje University Hospital.

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Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Cross-sectional

• Performed at one institution

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Suh, Y.H., Kang, Y., Baek, M.J. et al. T2 relaxation time shortening in the cochlea of patients with sudden sensory neuronal hearing loss: a retrospective study using quantitative synthetic magnetic resonance imaging. Eur Radiol (2021). https://doi.org/10.1007/s00330-021-07749-5

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Keywords

  • Hearing loss, sensorineural
  • Hearing loss, sudden
  • Cochlea
  • Synthetic magnetic resonance imaging
  • Quantitative evaluation