Preliminary Diagnosis: Meniere’s Disease
I. What imaging technique is first-line for this diagnosis
- CT temporal bone without contrast
II. Describe the advantages and disadvantages of this technique for diagnosis of Meniere’s disease.
Advantages
- Relatively inexpensive, fast imaging modality
- Better adept in detailing and characterizing the osseous structures than other imaging techniques
Disadvantages
- Exposes the patients to ionizing radiation
- Less specific and sensitive for characterizing the endolymphatic sac and vestibular system of the inner ear compared to companion MR imaging
III. What are the contraindications for the first-line imaging technique?
- May be contraindicated in pregnant patients
IV. What alternative imaging techniques are available?
- Contrasted MR of the temporal bone and inner ear
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of Meniere’s disease.
Contrasted MR of the temporal bone and inner ear
Advantages
- Better characterizes the endolymphatic sac and vestibular system within the membranous labyrinth than CT
- More specific and sensitive in detecting other potential temporal bone, inner ear, or retrocochlear abnormalities
Disadvantages
- Expensive
- Time-consuming
- Requires significant patient cooperation to minimize motion artifact
VI. What are the contraindications for the alternative imaging techniques?
Contrasted MR of the temporal bone and inner ear
- Contraindicated in patients with non-MR compatible hardware
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