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Background and Purpose: Imaging is fundamental to assessing the acoustic pathway in infants with congenital deafness. We describe our depiction of the membranous labyrinth in infants using the heavily T2-weighted 3D FLAIR sequence without a contrast agent., Materials and Methods: We retrospectively reviewed 10 infants (20 ears) (median term equivalent age: 2 weeks; IQR: 1-5 weeks) who had undergone brain MR imaging including a noncontrast heavily T2-weighted 3D FLAIR scan of the temporal bone. For each ear, 3 observers analyzed, in consensus, the saccule, the utricle, and the 3 ampullae, assessing the visibility (score 0, not appreciable; score 1, visible without well-defined boundaries; score 2, visible with well-defined boundaries) and morphology ("expected" or "unexpected" compared with adults). The heavily T2-weighted 3D FLAIR sequence was scored for overall quality (score 0, inadequate; score 1, adequate but with the presence of image degradation; score 2, adequate)., Results: Six (60%) MR examinations were considered adequate (score 1 or 2). The saccule was visible in 10 ears (83.3%) with an expected morphology in 9 ears (90%). In 1 ear of an infant with congenital deafness, the saccule showed an unexpected morphology. The utricle was visible as expected in 12 ears (100%). The lateral ampulla was visible in 5 ears (41.6%), the superior ampulla was visible in 6 ears (50.0%), and the posterior ampulla was visible in 6 ears (50.0%), always with expected morphology (100%)., Conclusions: MR imaging can depict the membranous labyrinth in infants using heavily T2-weighted 3D FLAIR without an injected contrast agent, but the sequence acquisition time reduces its feasibility in infants undergoing MR studies during natural sleep., (© 2021 by American Journal of Neuroradiology.)

Objective: The role of magnetic resonance (MR) imaging in idiopathic sudden sensorineural hearing loss (ISSHL) is controversial due to the inhomogeneity of clinical and MR protocols. The aim of this work is to relate early MR findings obtained immediately after the admission, with the clinical presentation, the audiological findings, and the outcomes of treatment., Study Design: Prospective observational study., Setting: Tertiary referral university center., Patients: Forty-seven patients (22 M, 25 F; age: 54.4 ± 17.5 yr) consecutively referred to the Department of Emergency for ISSHL., Interventions: All patients underwent the diagnostic and therapeutic work-up for ISSHL, and MR imaging within 72 hours from the admission, independently of the symptoms onset. All patients received the same treatment (systemic steroid therapy, intratympanic steroid injection, and hyperbaric oxygen therapy)., Main Outcome Measure(s): MR patterns, clinical, and laboratory findings., Results: MR imaging was positive in 25 of 47 cases (53%), with a perfect agreement between clinical and MR examinations (Cohen K = 1) upon the affected ear. Three different radiological patterns were observed: labyrinthine haemorrhage (n = 5), acute inflammatory process (n = 14), isolated blood-labyrinth barrier breakdown (n = 6). By binary logistic regression, only vertigo was associated with a positive MR imaging [B = 2.8; p = 0.011; OR = 9.5 (95% CI: 2.2-40.8)] and the latter was the only variable associated with an unfavorable outcome [(B = 2.8; p = 0.02 OR = 12.8 (95% CI: 2.9-56.7)]., Conclusion: Patients affected by ISSHL with associated vertigo show a higher likelihood of having a positive MR imaging, which, in turn, seems to predict an unfavorable outcome.

Ménière's disease (MD) is a chronic condition characterised by fluctuating hearing loss, intermittent vertigo, tinnitus and aural fullness. Its anatomical and pathological counterpart is represented by endolymphatic hydrops (EH). Recent development and progress in magnetic resonance (MR) imaging techniques has enabled visualisation of EH in living human subjects using a 3 Tesla (T) scanner and gadolinium-based contrast-agent (GBCA) via intravenous (IV) or intra-tympanic (IT) administration. Data emerging from the literature about MR imaging of EH in MD patients are limited, and we therefore reviewed the most common MR imaging findings in the study of the endolymphatic space in both MD and non-MD patients., (Copyright © 2018 Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.)

We report a case of a 57-year-old man with bilateral masses in the internal auditory canal. The peculiar findings at magnetic resonance imaging with tridimensional fluid-attenuated inversion recovery sequence combined with clinical data provided new insights into understanding the pathophysiology of the hearing loss.

Sudden sensorineural hearing loss is defined as acute hearing loss of the sensorineural type of at least 30 dB over 3 contiguous frequencies that occurs within a 72-hour period. Although many different causative factors have been proposed, sudden sensorineural hearing loss is still considered "idiopathic" in 71%-85% of cases, and treatments are empiric, not based on etiology. MR imaging implemented with a 3D FLAIR sequence has provided new insights into the etiology of sudden sensorineural hearing loss. Herein, we review the current management trends for patients with sudden sensorineural hearing loss, from the initial clinical diagnosis to therapeutic strategies and diagnostic work-up. We focused primarily on MR imaging assessment and discuss the relevance that MR imaging findings might have for patient management, pointing out different perspectives for future clinical research., (© 2017 by American Journal of Neuroradiology.)

Inflammatory myofibroblastic tumors include a diverse group of lesions characterized by inflammatory cell infiltration and variable fibrotic responses. Occurrence in the temporal bone is unusual. We present CT and MR imaging findings of an inflammatory myofibroblastic tumor of the temporal bone in a 26-year-old patient with repeated paroxystic episodes of rotatory vertigo that occurred over a few days. CT and MR imaging revealed a homogeneously enhancing soft-tissue mass of the right mastoid with bone erosion of the tegmen and extensive dural thickening. The mass resembled a malignant tumor, and the patient underwent an extended mastoidectomy through a retroauricular approach. Microscopic examination showed myofibroblastic spindle cells with mixed inflammatory infiltrate, and the pathologic diagnosis was inflammatory myofibroblastic tumor.

The results of the recording of the Auditory Brainstem Responses (ABR) in 32 patient with "definite" multiple sclerosis (MS) according to Poser et al. (1983) were contrasted with the brain stem anatomic lesions evidenced by Magnetic Resonance Imaging (MRI) and with the neurologic signs and symptoms found at clinical examination (BS). Twenty-one patients showed ABR abnormalities (65.5%); in 15 cases MRI visualized demyelinization plaques in the brain stem (46.8%); 12 patients had neurological signs of brain stem involvement (37.5%) at the time of the electrophysiological and radiological assessment. When the observation was restricted to the group of 21 patients with past or present BS neurological signs, ABR sensitivity resulted 81% (17/21), while MRI obtained a value of 57% (12/21).