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MRI of cochlear otosclerosis

¹ Department of Diagnostic Radiology, Tan Tock Seng Hospital, ² Department of Diagnostic Radiology, Singapore General Hospital and ³ Department of Radiology, Changi General Hospital, Singapore

Cochlear otosclerosis is an uncommon cause of mixed and sensorineural hearing loss. This has a characteristic appearance on CT, producing a distinctive pericochlear hypodense double ring. However, its appearance on MRI is not as readily appreciated, producing a ring of intermediate signal in the pericochlear and perilabyrinthine regions on T₁ weighted images, demonstrating mild to moderate enhancement after gadolinium administration. Increased signal on T₂ weighted images may also be seen. Recognition of these MRI features is important as MRI may be the first modality of investigation, especially when patients present with symptoms indicative of sensorineural hearing loss. We review four patients who presented with sensoineural hearing loss, and who were imaged with MRI as the first line of investigation.

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