Comparison of Contrast Effect on the Cochlear Perilymph after Intratympanic and Intravenous Gadolinium Injection

BACKGROUND AND PURPOSE: 3D-FLAIR imaging 24 hours after intratympanic gadolinium injection (IT-method) or 4 hours after IV injection (IV-method) has been used to visualize the endolymphatic hydrops in Meniere disease. The purpose of this study was to compare the degree of perilymph enhancement with the 2 methods and the perilymph contrast-effect difference with the IV-method in both sides in patients with unilateral Meniere disease. MATERIALS AND METHODS: Sixty-one patients with Meniere disease or sudden SNHL were included in this study. Thirty-nine patients who underwent the unilateral IT-method (Gd-DTPA was diluted 8-fold with saline) and 22 patients who underwent the IV-method (a double-dose of Gd-HP-DO3A; 0.4 mL/kg body weight lie, 0.2 mmol/kg body weight]) at 3T were analyzed retrospectively. Regions of interest of the cochlear perilymph and the medulla oblongata were determined on each image, and the signal-intensity ratio between the 2 (CM ratio) was subsequently evaluated. The differences in the CM ratio between the 2 methods (Student t test) and the IV-method CM ratio between the affected and unaffected sides in patients with unilateral Meniere disease (paired t test) were evaluated. RESULTS: The IT-method CM ratio (2.98 +/- 1.15, n = 39) was higher than the IV-method CM ratio (1.61 +/- 0.60, n = 44; P < .001). In patients with unilateral Meniere disease who underwent the IV-method In = 9), the CM ratio of the affected side (1.86 +/- 0.74) was higher than that of the unaffected side (1.29 +/- 0.31, P < .05). CONCLUSIONS: In general, the IT-method provides higher perilymph enhancement than the IV-method. In the patients with unilateral Meniere disease who underwent the IV-method, the affected side had a higher contrast effect.