Introduction Intravenous gadolinium administration has been shown to be useful in the evaluation of the blood-labyrinthine barrier in patients with inner ear disease. However, the time point between administration of contrast agent and imaging may be critical for the identification of pathological enhancement as a result of a possibly pathological permeability of the blood-labyrinthine barrier.
Methods Late imaging after intravenous administration and subsequent magnetic resonance tomography in 5 patients showed pathological enhancement. These cases were analyzed retrospectively for the clinical presentation of inner ear disease.
Results All cases with late intracochlear enhancement were female. Their age ranged between 20 and 56 years. Three patients suffered from sudden acute or even chronic hearing loss, one from over years progressing hearing loss and one from vestibular neuritis.
Conclusions Late enhancement in magnetic resonance tomography of the inner ear may be underestimated in regular imaging after intravenous administration of gadolinium. All patients showed a diverse course and presentation of disease. Whether the enhancement is due to specific or unspecific inflammation of the inner ear needs further investigation. To this aim, combined analysis of perilymph sampling and imaging would be helpful.
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