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Bouhadjer K, Romo LV, Brennan MJ, Kozak BM, Hattingen E, Juliano AF, Curtin HD, Reinshagen KL. Retrospective Analysis of the Association of a Small Vestibular Aqueduct with Cochleovestibular Symptoms in a Large, Single-Center Cohort Undergoing CT. AJNR Am J Neuroradiol 2023; 44:70-73. [PMID: 36521965 PMCID: PMC9835903 DOI: 10.3174/ajnr.a7734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Temporal bones in some patients with Ménière disease have demonstrated small vestibular aqueducts; however, the prevalence and clinical importance of small vestibular aqueducts remain unclear in patients without Ménière disease. This study correlates the presence of a small vestibular aqueduct with cochleovestibular symptoms. MATERIALS AND METHODS Consecutive temporal bone CTs in adults from January to December 2020 were reviewed. The midpoint vestibular aqueduct size in the 45°-oblique Pöschl view was measured by 2 reviewers independently in 684 patients (1346 ears). Retrospective chart review for the clinical diagnosis of Ménière disease, the presence of cochleovestibular symptoms, and indications for CT was performed. RESULTS Fifty-two of 684 patients (7.6% of patients, 62/1346 ears) had small vestibular aqueducts. Twelve patients (15/1346 ears) had Ménière disease. Five of 12 patients with Ménière disease (5 ears) had a small vestibular aqueduct. There was a significant correlation between a small vestibular aqueduct and Ménière disease (P < .001). There was no statistical difference between the small vestibular aqueduct cohort and the cohort with normal vestibular aqueducts (0.3-0.7 mm) regarding tinnitus (P = .06), hearing loss (P = .88), vertigo (P = .26), dizziness (P = .83), and aural fullness (P = .61). CONCLUSIONS While patients with Ménière disease were proportionately more likely to have a small vestibular aqueduct than patients without Ménière disease, the small vestibular aqueduct was more frequently seen in patients without Ménière disease and had no correlation with hearing loss, vertigo, dizziness, or aural fullness. We suggest that the finding of a small vestibular aqueduct on CT could be reported by radiologists as a possible finding in Ménière disease, but it remains of uncertain, and potentially unlikely, clinical importance in the absence of symptoms of Ménière disease.
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Affiliation(s)
- K Bouhadjer
- From the Department of Radiology (K.B., L.V.R., M.J.B., A.F.J., H.D.C., K.L.R.), Massachusetts Eye and Ear, Boston, Massachusetts
| | - L V Romo
- From the Department of Radiology (K.B., L.V.R., M.J.B., A.F.J., H.D.C., K.L.R.), Massachusetts Eye and Ear, Boston, Massachusetts
| | - M J Brennan
- From the Department of Radiology (K.B., L.V.R., M.J.B., A.F.J., H.D.C., K.L.R.), Massachusetts Eye and Ear, Boston, Massachusetts
| | - B M Kozak
- Neuroradiology Division (B.M.K.), Massachusetts General Hospital, Boston, Massachusetts
| | - E Hattingen
- Institut für Neuroradiologie (E.H.), Universitätsmedizin der Goethe Universität Frankfurt, Frankfurt am Main, Germany
| | - A F Juliano
- From the Department of Radiology (K.B., L.V.R., M.J.B., A.F.J., H.D.C., K.L.R.), Massachusetts Eye and Ear, Boston, Massachusetts
| | - H D Curtin
- From the Department of Radiology (K.B., L.V.R., M.J.B., A.F.J., H.D.C., K.L.R.), Massachusetts Eye and Ear, Boston, Massachusetts
| | - K L Reinshagen
- From the Department of Radiology (K.B., L.V.R., M.J.B., A.F.J., H.D.C., K.L.R.), Massachusetts Eye and Ear, Boston, Massachusetts
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Levy M, Chwalisz BK, Kozak BM, Yoon MK, Shih HA, Stagner AM. Case 36-2022: A 30-Year-Old Woman with Decreased Vision and Headache. N Engl J Med 2022; 387:1980-1989. [PMID: 36416771 DOI: 10.1056/nejmcpc2211355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Michael Levy
- From the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Massachusetts General Hospital, the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Ophthalmology (M.K.Y.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Harvard Medical School, and the Department of Ophthalmology, Massachusetts Eye and Ear (B.K.C., M.K.Y., A.M.S.) - all in Boston
| | - Bart K Chwalisz
- From the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Massachusetts General Hospital, the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Ophthalmology (M.K.Y.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Harvard Medical School, and the Department of Ophthalmology, Massachusetts Eye and Ear (B.K.C., M.K.Y., A.M.S.) - all in Boston
| | - Benjamin M Kozak
- From the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Massachusetts General Hospital, the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Ophthalmology (M.K.Y.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Harvard Medical School, and the Department of Ophthalmology, Massachusetts Eye and Ear (B.K.C., M.K.Y., A.M.S.) - all in Boston
| | - Michael K Yoon
- From the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Massachusetts General Hospital, the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Ophthalmology (M.K.Y.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Harvard Medical School, and the Department of Ophthalmology, Massachusetts Eye and Ear (B.K.C., M.K.Y., A.M.S.) - all in Boston
| | - Helen A Shih
- From the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Massachusetts General Hospital, the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Ophthalmology (M.K.Y.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Harvard Medical School, and the Department of Ophthalmology, Massachusetts Eye and Ear (B.K.C., M.K.Y., A.M.S.) - all in Boston
| | - Anna M Stagner
- From the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Massachusetts General Hospital, the Departments of Neurology (M.L., B.K.C.), Radiology (B.M.K.), Ophthalmology (M.K.Y.), Radiation Oncology (H.A.S.), and Pathology (A.M.S.), Harvard Medical School, and the Department of Ophthalmology, Massachusetts Eye and Ear (B.K.C., M.K.Y., A.M.S.) - all in Boston
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Abstract
Long acquisition times can limit the use of MRI in pediatric patients, and the use of sedation or general anesthesia is frequently necessary to facilitate diagnostic examinations. The use of sedation or anesthesia has disadvantages including increased cost and imaging time and potential risks to the patient. Reductions in imaging time may decrease or eliminate the need for sedation or general anesthesia. Over the past decade, a number of imaging techniques that can decrease imaging time have become commercially available. These products have been used increasingly in clinical practice and include parallel imaging, simultaneous multisection imaging, radial k-space acquisition, compressed sensing MRI reconstruction, and automated protocol selection software. The underlying concepts, supporting data, current clinical applications, and available products for each of these strategies are reviewed in this article. In addition, emerging techniques that are still under investigation may provide further reductions in imaging time, including artificial intelligence-based reconstruction, gradient-controlled aliasing sampling and reconstruction, three-dimensional MR spectroscopy, and prospective motion correction. The preliminary results for these techniques are also discussed. ©RSNA, 2020 See discussion on this article by Greer and Vasanawala.
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Affiliation(s)
- Benjamin M Kozak
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Founders 210, Boston, MA 02114 (B.M.K., J.K., M.S.G.); Department of Radiology, Harvard Medical School, Boston, Mass (B.M.K., C.J., J.K., M.S.G.); and Department of Radiology, Boston Children's Hospital, Boston, Mass (C.J.)
| | - Camilo Jaimes
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Founders 210, Boston, MA 02114 (B.M.K., J.K., M.S.G.); Department of Radiology, Harvard Medical School, Boston, Mass (B.M.K., C.J., J.K., M.S.G.); and Department of Radiology, Boston Children's Hospital, Boston, Mass (C.J.)
| | - John Kirsch
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Founders 210, Boston, MA 02114 (B.M.K., J.K., M.S.G.); Department of Radiology, Harvard Medical School, Boston, Mass (B.M.K., C.J., J.K., M.S.G.); and Department of Radiology, Boston Children's Hospital, Boston, Mass (C.J.)
| | - Michael S Gee
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Founders 210, Boston, MA 02114 (B.M.K., J.K., M.S.G.); Department of Radiology, Harvard Medical School, Boston, Mass (B.M.K., C.J., J.K., M.S.G.); and Department of Radiology, Boston Children's Hospital, Boston, Mass (C.J.)
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