Imaging of endolymphatic hydrops at 7T MRI
Research type
Research Study
Full title
Imaging endolymphatic hydrops at 7T MRI: validation of internal inner ear structures on T2w as markers of endolymphatic hydrops and a comparison of diagnostic outcomes with 3T MRI
IRAS ID
259867
Contact name
Stephen Connor
Contact email
Sponsor organisation
King's College London
Clinicaltrials.gov Identifier
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Meniere’s Disease (MD) is an inner ear (IE) disorder characterised by episodic attacks of vertigo and progressive hearing loss. The dizzy spells in particular can be severely disabling. The structural correlate of MD is endolymphatic hydrops (EH), in which the smaller central endolymphatic compartment of IE expands into the surrounding perilymphatic chambers. The diagnosis of MD can be elusive since it relies on subjective reporting of symptoms and definitive diagnostic tests have yet to be established.
The currently available high resolution T2-weighted (T2w) MRI sequences are unable to distinguish the different compartments within IE. Recent developments in MRI technology and techniques, however, have enabled visualisation of the different IE compartments and demonstration of EH. The clinical application of high resolution sequences at 3T (T=Tesla, a measure of the magnetic field strength) with delayed post intravenous gadolinium studies is now being explored. Identification of radiologically EH may facilitate earlier diagnosis, thus guiding future treatment. It may also provide useful information in difficult cases where the diagnosis is not clear cut. Furthermore, the identification of bilateral changes in a patient with unilateral fluctuating symptoms might predict future bilateral disease and potentially influence therapeutic approaches, which is particularly important when considering the more invasive/irreversible treatment options.
Although significant progress has been made, there are still a number of deficiencies, which we propose to address in this study. Firstly, due to the small size of the structures being imaged and artefacts from the surrounding structures, accurate delineation of some of the structures still is very challenging; imaging at 7T may allow superior definition of these structures, enhancing diagnostic confidence. Secondly, it is possible that high resolution T2w imaging at 7T will allow reproducible detection of internal IE structures which correlate with the size of endolymphatic structures on the 3T current protocol, thus obviating the need for a delayed intravenous contrast study.
REC name
South West - Frenchay Research Ethics Committee
REC reference
20/SW/0085
Date of REC Opinion
16 Jun 2020
REC opinion
Further Information Favourable Opinion