Abstract: Objective To analyze the possible causes of poor development of imaging in patients undergoing three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging(3D-FLAIR MRI)after intratympanic gadolinium injection in our hospital in recent years and propose possible solutions. Methods This study enrolled a total of 356 patients and 706 ears between January 2017 and June 2020. All patients underwent 3D-FLAIR MRI through intratympanic gadolinium injection. The imaging was poorly developed for a total of 55 patients(70 ears). The possible causes of poor development were analyzed. Results Poor images was obtained in 70 ears, including 16 instances in which the signal was not as strong as normal, 14 that were not filled contiguously, and 40 that showed no contrast agent in the inner ear on imaging. A total of 39 ears had simple ipsilateral otitis media as revealed by imaging; among those with chronic otitis media or occult otitis media, 11 showed poor visualization(28.2%). Imaging was poor for four(12.5%)out of 32 ears with sinusitis. Among the three ears with both otitis media and sinusitis, imaging was poor for one ear(33.3%). Among the 632 ears without otitis media/sinusitis, imaging was poor for only 54 ears(8.5%). A statistically significant difference was observed between combined and non-combined otitis media, but not between those non-combined,combined rhinosinusitis, as sell as those conbined with otitis media and nasosinusitis. Conclusion When gadolinium is injected into the inner ear through the tympanum, though excluding a recent history of otitis media, chronic or occult otitis media may still be influencing factors for poor imaging development. The present article further discusses other possible influencing factors in each link of angiography and suggests avoiding them to improve the success rate of inner ear gadolinium angiography.

Key words: Intratympanic gadolinium, Magnetic resonance imaging, Poor development, Otitis media, Nasasinusitis