MRA Head and Neck Without and With IV Contrast There is no relevant literature regarding the use of MRA head and neck without and with IV contrast in the evaluation of suspected MD. MRA Head and Neck Without IV Contrast There is no relevant literature regarding the use of MRA head and neck without IV contrast in the evaluation of suspected MD. MRI Cervical and Thoracic Spine With IV Contrast There is no relevant literature regarding the use of MRI cervical and thoracic spine with IV contrast in the evaluation of suspected MD. MRI Cervical and Thoracic Spine Without and With IV Contrast There is no relevant literature regarding the use of MRI cervical and thoracic spine without and with IV contrast in the evaluation of suspected MD. MRI Cervical and Thoracic Spine Without IV Contrast There is no relevant literature regarding the use of MRI cervical and thoracic spine without IV contrast in the evaluation of suspected MD. Dizziness and Ataxia Highly specialized techniques with high resolution such as delayed 3-D fluid-attenuated inversion recovery (FLAIR), inversion recovery turbo spin-echo with real reconstruction (3-D real-inversion recovery), and imaged after gadolinium administration demonstrates accumulation of gadolinium in the endolymphatic sac [53-57]. Intratympanic gadolinium may also be performed but is more invasive [58,59]. Some studies used double dose contrast. Volumetric assessment with ratio of endolymph to perilymph volume in the cochlea and vestibule are performed. Endolymphatic hydrops and grading on MRI in patients with MD has shown correlation with clinical symptoms in multiple studies [52,60-64] and histopathologic specimens [65]. The vestibular endolymphatic space contacting the oval window has a high specificity and positive predictive value in differentiating MD ears from other ears in a small study [66].
Dizziness and Ataxia. MRA Head and Neck Without and With IV Contrast There is no relevant literature regarding the use of MRA head and neck without and with IV contrast in the evaluation of suspected MD. MRA Head and Neck Without IV Contrast There is no relevant literature regarding the use of MRA head and neck without IV contrast in the evaluation of suspected MD. MRI Cervical and Thoracic Spine With IV Contrast There is no relevant literature regarding the use of MRI cervical and thoracic spine with IV contrast in the evaluation of suspected MD. MRI Cervical and Thoracic Spine Without and With IV Contrast There is no relevant literature regarding the use of MRI cervical and thoracic spine without and with IV contrast in the evaluation of suspected MD. MRI Cervical and Thoracic Spine Without IV Contrast There is no relevant literature regarding the use of MRI cervical and thoracic spine without IV contrast in the evaluation of suspected MD. Dizziness and Ataxia Highly specialized techniques with high resolution such as delayed 3-D fluid-attenuated inversion recovery (FLAIR), inversion recovery turbo spin-echo with real reconstruction (3-D real-inversion recovery), and imaged after gadolinium administration demonstrates accumulation of gadolinium in the endolymphatic sac [53-57]. Intratympanic gadolinium may also be performed but is more invasive [58,59]. Some studies used double dose contrast. Volumetric assessment with ratio of endolymph to perilymph volume in the cochlea and vestibule are performed. Endolymphatic hydrops and grading on MRI in patients with MD has shown correlation with clinical symptoms in multiple studies [52,60-64] and histopathologic specimens [65]. The vestibular endolymphatic space contacting the oval window has a high specificity and positive predictive value in differentiating MD ears from other ears in a small study [66].