Improving diagnostic accuracy for probable and definite Meniere's disease using magnetic resonance imaging

PurposeTo determine whether magnetic resonance imaging (MRI) can improve diagnostic accuracy for definite and probable Meniere's disease (MD) based on perilymphatic enhancement (PE) and endolymphatic hydrops (EH).Methods363 patients with unilateral MD (probable MD, n = 75 and definite MD, n = 288) were recruited. A three-dimensional zoomed imaging technique with parallel transmission SPACE real inversion recovery was performed 6 h after intravenous gadolinium injection to investigate the presence of PE and to evaluate the grading and location of EH. PE and EH characteristics were analyzed and compared between the probable and definite MD groups.ResultsThe cochlear and vestibular EH grading on the affected side was more severe in the definite MD group than that in the probable MD group (P < 0.001). The EH locations within the inner ear on the affected side also differed between the two groups (chi(2) = 81.15, P < 0.001). The signal intensity ratio (SIR) on the affected side was significantly higher in the definite MD group than in the probable MD group (t = 2.18, P < 0.05). The assessment of the combination of PE and EH parameters within the inner ear revealed a higher area under the curve (AUC) in the definite MD group (0.82) compared with the AUCs of the parameters assessed alone.ConclusionThe assessment of a combination of PE and EH parameters improved the diagnostic accuracy for probable and definite MD, suggesting that MRI findings may be clinically useful in the diagnosis of MD.

Automated summary

This study aimed to investigate whether magnetic resonance imaging (MRI) can improve the diagnosis accuracy of probable and definite Meniere's disease (MD) through perilymphatic enhancement (PE) and endolymphatic hydrops (EH). The results showed that the combination evaluation of PE and EH parameters can enhance the diagnostic accuracy of probable and definite MD, suggesting that MRI findings are clinically valuable in the diagnosis of MD.