Iaia, A

MIDIRI, Massimo

PALERMO PATERA, Giovanni

SPARACIA, Gianvincenzo

Archivio istituzionale della ricerca - Università di Palermo

ASNR  2007: PROCEEDINGSCHICAGO, ILLINOIS2007JUNE 11 - 14, 2007HYATT REGENCY CHICAGOCHICAGO, ILLINOISAMERICAN SOCIETY OF NEURORADIOLOGYIncludes Interactive CD-ROM2007 PROCEEDINGSPLATINUM LEVELSILVER LEVELGOLD LEVELPROGRAM CONTRIBUTORSAn educational grant in support of the NER Foundation Symposium 2007: The Aging BrainBayer HealthCare Pharmaceuticals/NER FoundationFellowship in Basic Science ResearchAnnual Bayer HealthCare Pharmaceuticals OutstandingPresentation Award in General NeuroradiologyAnnual educational grant in support of theMaintenance of Certification (MOC) andSelf Assessment Modules (SAM)1 programming live and on the ASNR website(Formerly Berlex)1Programming is currently under review for Self Assessment Modules (SAM) credit through the American Board of Radiology (ABR) for approval.5642 Cover_wb:proceeding_concepts07  4/29/07  4:37 PM  Page 1CONCLUSIONAlterations in labyrinthine fluid signal intensity induced byIAC vestibular schwannomas can be detected using this 3DFLAIR technique. Further study with audiometric correla-tion is warranted to determine if these signal changes haveany prognostic significance.KEY WORDS: 3D Flair MR imaging, temporal bone, vestibu-lar schwannoma Paper 71 Starting at 3:39 PM, Ending at 3:47 PM MR Imaging of the Membranous Labyrinth at 3TMorris, J. M.1 · Lane, J. I.1 · Johnson, K. J.2 · Bolster, B.2 ·Horger, W.2 · Witte, R. J.11Mayo Clinic, Rochester, MN, 2Siemens Medical Solutions,Malvern, PAPURPOSEClinical MR imaging of the inner ear has been limited todemonstrating fluid signal intensity within the bonylabyrinth on T2-weighted sequences. However, recentadvances in image acquisition techniques and hardware arecapable of generating resolution and contrast sufficient todifferentiate tissue in these structures in scan times that areclinically feasible. We describe our efforts to directly visual-ize the membranous labyrinth at 3T.MATERIALS & METHODSSix volunteers were imaged on a 3T MR unit (MagnetomTim Trio, Siemens Medical Solutions, Erlangen, Germany).Either 7 cm loop coils or 4 ch flex coils were centered overthe external auditory canal and used to acquire 3D T2SPACE in the axial plane through the IAC with a 10 cmFOV, 294 x 320 matrix and 0.3 mm partitions, yielding 0.3mm isotropic resolution. Reference was made to an ex vivoT2-weighted dataset of a cadaver temporal bone specimenscanned at 9.4T (Oxford vertical bore) for positive identifi-cation of membranous labyrinthine structures.RESULTSAs seen in Figure 1, we could reliably identify the utricularmacula as a curvilinear area of relative T2 hypointensityalong the anterior margin of the utricle within the vestibuleof the inner ear. The crista ampullaris of the semicircularducts were apparent but less conspicuous within the ampul-lae of the semicircular canals. We currently are unable toresolve the saccule and scala media within the cochlea usingthis technique.Figure 1. Left, 3T MR image using 3D SPACE techniquedemonstrates low signal utricular macula of the membranouslabyrinth (arrow). Right, 9.4T T2-weighted image of cadav-er temporal bone demonstrates low signal macula (arrow). CONCLUSIONTo our knowledge, this is the first report of visualization ofthe membranous labyrinth on MR imaging. Further study iswarranted to improve spatial resolution and to evaluate theclinical utility in the assessment of cochleo-vestibular dis-ease.KEY WORDS: Membranous labyrinth, 3T MR imaging, tem-poral bone Paper 72 Starting at 3:47 PM, Ending at 3:55 PM Superior Canal Dehiscence: Multidetector-Row CTEvaluation Palermo Patera, G.1 · Iaia, A.2 · Sparacia, G.1 · Texeido, M.2 ·Midiri, M.11Policlinico Giaccone, Palermo, ITALY, 2Cristiana Care,Newark, CAPURPOSETo present a series of 26 patients, with clinical findings sug-gestive of superior canal dehiscence syndrome, who present-ed to a single otologic practice and to describe the clinicalworkup, common findings, surgical and conservative treat-ment of these patients.MATERIALS & METHODSRetrospective chart review of 26 patients seen with clinicalsymptoms attributed to superior canal dehiscence confirmedon high-resolution CT scan of the temporal bone. Along withthe CT scan, all patients underwent physical examination,audiogram and vestibular-evoked myogenic potentials.RESULTSThe charts of 16 females and 10 males (mean age 50) withunilateral otologic symptoms were reviewed. All patientshad dehiscence of the superior semicircular canal seen on CTscan of the temporal bone on the ipsilateral side. To date fiveof the 26 patients have undergone transmastoid occlusion ofthe superior semicircular canal with significant improvementin clinical symptoms.CONCLUSIONAll patients reviewed presented with various complaints ofsound-induced nausea or vertigo, aural pressure, hyperacu-sis, autophony generalized disequilibrium and hearing loss.These symptoms all can be easily attributable to other com-mon otologic conditions such as perilymph fistula, otoscle-rosis, hydrops or eustachian tube dysfunction. Patients withsuperior canal dehiscence syndrome may not present withthe classic Tullio phenomenon and symptomatology. Fewpatients with symptomatic superior canal dehiscence electsurgical treatment. Making the correct diagnosis with thecombination of clinical history, audiologic evaluation,VEMP, properly formatted CT scans and high clinical suspi-cion can save patients from unnecessary and potentiallyharmful treatments such as stapedectomy or perilymph fistu-la repair. KEY WORDS: Sparacia 39Monday

Superior Canal Dehiscence: Multidetector-Row CT
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Superior Canal Dehiscence: Multidetector-Row CT Evaluation

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