Disrupted blood-labyrinthine barrier revealed by MRI in patients with sudden sensorineural hearing loss

Abstract

Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) has recently been developed to detect high concentrations of protein or hemorrhage. Two-thirds of patients with sudden sensorineural hearing loss showed high-intensity signals in the affected inner ear on precontrast 3D-FLAIR at 3 Tesla. Postcontrast enhancement was recognized after intravenous gadolinium administration in a half of the inner ears showing precontrast high-intensity signals. Abnormal passage of the gadolinium reflects increased permeability of blood vessels or disruption of the blood-labyrinthine barrier in the inner ears. We hypothesized that glucocorticoids, which have anti-inflammatory actions and suppress the increased permeability of blood vessels, are effective in some cases showing postcontrast enhancement. Experimental and clinical reports on disrupted blood-labyrinthine barrier were reviewed.