Official Title

Magnetic Resonance Imaging Evaluation of Inner Ear Pathology Using Intra-Tympanic Contrast Agent
  • Phase

  • Study Type

  • Study Participants

This is a pilot study of patients with clinical symptoms of Ménière's disease using injection of diluted magnetic resonance imaging (MRI) contrast agent into the ear to evaluate inner ear structures.

The goal is to reproduce imaging findings described by non-United States (US) institutions, improve on image quality with decreased scan time and evaluate the dynamics of the contrast movement into the inner ear structures.
Participants will be scheduled for study sessions on 2 consecutive days to include consent, baseline audiometric evaluation, intra-tympanic contrast administration, serial MR imaging, and follow-up audiometry evaluation in the injected ear.

Participants over 59 years old or who have medical conditions will have a blood test to check kidney function to ensure they can safely receive the contrast.
Study Started
Jan 31
Primary Completion
Dec 31
Study Completion
Dec 31
Results Posted
Feb 12
Last Update
Feb 12

Drug Magnevist (gadopentetate dimeglumine)

intratympanic injection Experimental

Magnevist (gadopentetate dimeglumine, Bayer Health Care) will be diluted eightfold with sterile saline (1:7 v/v) in a 1 ml syringe and injected intra-tympanically with a 23-25g needle up to 0.4 ml or less if contrast reflux is noted under direct visualization. Anesthesia with topical phenol is available for this procedure.


Inclusion Criteria:

Symptoms and clinical exam consistent with Ménière's disease
Ability to undergo MR exam
Interest in participating in this study
Ability to provide informed consent

Exclusion Criteria:

Children (under age 18),
Contraindication to MR imaging (see attached UCSD MR Screening Form)
Claustrophobia precluding MR exam without sedation
Contraindication to receiving intravenous gadolinium-based contrast agent (see attached UCSD Contrast Policy)
Patients who are pregnant or breast feeding (intravenous contrast agents are Category C)
Contraindication to osmotic challenge (congestive heart failure, renal failure, hepatic failure)


Intratympanic Injection

All Events

Event Type Organ System Event Term

Vestibular "Endolymphatic Hydrops (EH)"

The relative volume of the non-enhancing endolymphatic space was visually assessed relative to the enhancing perilymphatic space on delayed post-IT contrast FLAIR MRI sequences and characterized as <34%, 34-50% or >50% of endolymphatic/perilymphatic volume.

Intratympanic Injection

Vestibular EH < 34%

Vestibular EH 34-50%


Vestibular EH >50%


Cochlear "Endolymphatic Hydrops (EH)"

The relative volume of the scala media of the basal turn of the cochlea (non-enhancing endolymph) was visually assessed relative to the scala tympani and scala vestibuli (enhancing perilymph) on delayed post-IT contrast FLAIR MRI sequences. Cases were characterized as: No Cochlear EH (no perceptible distention of the scala media), Cochlear EH (perceptible distention of the scala media), or Absent enhancement (no contrast in the cochlear perilymph)

Intratympanic Injection

Absent enhancement

Cochlear EH


No Cochlear EH

Extension of Contrast From Perilymph to CSF

The fundus of the internal auditory canal (IAC) was visually inspected to determine if there was conspicuous, subtle, or no enhancement extending in the setting of prior IT contrast injection, indicating permeability of the cochlear modiolus.

Intratympanic Injection

Conspicuous enhancement in IAC


No enhancement in IAC


Subtle enhancement in IAC


Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Intratympanic Injection