47 year old with vertigo and sudden bilateral hearing loss





T1 axial noncontrast



T1 coronal noncontrast





Findings:

T1 shortening in the labyrinth bilaterally

DDX:

labyrinthitis (viral), hemolabyrinth (coagulopathy or trauma), 






Diagnosis:

Hemolabyrinth in setting of Waldenstrom's macroglobulinemia with hyperviscosity

Discussion:

Precontrast T1 imaging of the temporal bone may rarely be helpful in distinguishing intrinsic T1 shortening (blood products or proteinacous fluid) from enhancement.



Submitted by Dean Shibata, MD, UW Neuroradiology

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