Isolated enhancement of the superior semi-circular canal on inner ear MRI: acute vestibular syndrome or superior semi-circular canal dehiscence?

Abstract

Purpose

Recently, it has been reported that patients with acute vestibular syndrome (AVS) could present a marked enhancement of the semi-circular canals, involving mostly the superior semi-circular canals on delayed inner ear MRI.

Methods

We reported one patient having AVS and another one having superior semi-circular canal dehiscence syndrome (SCDS) who underwent delayed inner ear MRI performed 4 h after contrast media administration.

Results

On delayed inner ear MRI, a marked enhancement of the superior semi-circular canal was observed in both patients. Although the clinical presentation is clearly not the same, the co-existence between these two disorders is possible. For this reason, in patients with AVS, the presence of a marked enhancement of the superior semi-circular canal should rule out the presence of a co-existing SCDS on temporal bone CT, particularly if the patient reported cochlear symptoms such as pulsatile tinnitus and/or autophony.

Conclusion

To our knowledge, this is the first report showing this finding on delayed inner ear MRI in a patient with SCDS. In AVS patients, this radiological anomaly could be particularly disturbing and should rule out the presence of a co-existing SCDS.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig.2
Fig. 3
Fig. 4

References

  1. 1.

    Nakashima T, Naganawa S, Pyykko I et al (2009) Grading of endolymphatic hydrops using magnetic resonance imaging. Acta Oto Laryngol Suppl 560:5–8

    Article  Google Scholar 

  2. 2.

    Tagaya M, Yamazaki M, Teranishi M et al (2011) Endolymphatic hydrops and blood-labyrinth barrier in ménière’s disease. Acta Otolaryngol 131(5):474–479

    CAS  Article  Google Scholar 

  3. 3.

    Conte G, Di Berardino F, Zanetti D et al (2019) Early magnetic resonance imaging for patients with idiopathic sudden sensorineural hearing loss in an emergency setting. Otol Neurotol 40:1139–1147

    Article  Google Scholar 

  4. 4.

    Eliezer M, Toupet M, Guichard J-P et al (2019) Cochleovestibular artery syndrome: consideration based on VHIT, VEMP, and inner ear MRI. J Neurol. https://doi.org/10.1007/s00415-019-09407-9

    Article  PubMed  Google Scholar 

  5. 5.

    Eliezer M, Verillaud B, Guichard J-P et al (2019) Labyrinthine infarction caused by vertebral artery dissection: consideration based on MRI. J Neurol. https://doi.org/10.1007/s00415-019-09456-0

    Article  PubMed  Google Scholar 

  6. 6.

    Eliezer M, Maquet C, Horion J et al (2019) Detection of intralabyrinthine abnormalities using post-contrast delayed 3D-FLAIR MRI sequences in patients with acute vestibular syndrome. Eur Radiol 29:2760–2769

    Article  Google Scholar 

  7. 7.

    Manzari L, Burgess AM, MacDougall HG, Curthoys IS (2015) Superior canal dehiscence reveals concomitant unilateral utricular loss (UUL). Acta Otolaryngol 135(6):557–564

    Article  Google Scholar 

  8. 8.

    Kahn L, Hautefort C, Guichard JP et al (2019) Relationship between VHIT, cVEMP and oVEMP and compartmental MRI classification in menière’s disease. Laryngoscope. https://doi.org/10.1002/lary.28362

    Article  PubMed  Google Scholar 

  9. 9.

    Eliezer M, Attyé A, Guichard J-P et al (2019) Vestibular atelectasis: myth or reality? Laryngoscope 129:1689–1695

    CAS  Article  Google Scholar 

  10. 10.

    Naganawa S (2015) The technical and clinical features of 3D-FLAIR in neuroimaging. Magn Reson Med Sci 14:93–106

    Article  Google Scholar 

Download references

Funding

No financial disclosure.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Michael Eliezer.

Ethics declarations

Conflict of interest

There is no conflict of interest declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Eliezer, M., Toupet, M., Guichard, JP. et al. Isolated enhancement of the superior semi-circular canal on inner ear MRI: acute vestibular syndrome or superior semi-circular canal dehiscence?. Eur Arch Otorhinolaryngol 277, 3217–3221 (2020). https://doi.org/10.1007/s00405-020-06058-9

Download citation

Keywords

  • Inner ear
  • MRI
  • 3D-FLAIR
  • Acute vestibular syndrome
  • Superior semi-circular syndrome dehiscence