Visualization of endolymphatic hydrops and correlation with audio-vestibular functional testing in patients with definite Meniere's disease

Validity and Reliability of the Diagnostic Tests for Ménière's Disease

“…It was reported that the degree and location of hydrops that is demonstrated radiologically was compatible with the severity of hearing loss and vestibular dysfunction (56), and MRI findings were correlated with patient's history (audiological and vestibular symptoms), ECoG, and VEMP (57). While the sensitivity of 3T MRI in the diagnosis of MD, performed after intratympanic gadolinium injection, was found to be 95%, the sensitivity of other diagnostic tests was 55% for the glycerol test, 60% for ECoG, and 75% for the combination of ECoG and glycerol tests (57).…”

Intratympanic Contrast in the Evaluation of Meniere Disease: Understanding the Limits

“…Nevertheless, series have not found a reliable correlation between the extent of en- dolymphatic distention and patient response to subsequent IT steroids, 16,18 and there has been variable correlation between imaging with summating potential/action potential ratios electrocochleography and vestibular-evoked myogenic potential. 17,25,31 These outcomes may be partially due to lack of standardization of criteria for severity based on imaging findings 8,12,13 but also may reflect the spectrum of findings through the range associated with the natural history of Menière disease. The delayed post-IT injection FLAIR sequence should be interpreted with multiplanar projections, to avoid interpretation errors due to partial volume averaging as illustrated in Fig 2. Additionally, any nonstandard sequences must be reviewed in the context of a full IAC protocol, including fluid-sensitive, DWI, FLAIR, and postcontrast T1 sequences of the entire auditory pathway, to exclude a schwannoma 32 or other source of…”

“…7,[17][18][19] While the availability of 32-channel head coils has improved resolution to 0.4 ϫ 0.4 ϫ 0.8 mm, these volumetric sequences come at the cost of time, requiring up to 15 minutes for an acquisition, with potential for motion degradation and decreased SNR due to parallel imaging techniques. 20,21 A recent publication has shown reduced acquisition time to 5 minutes 26 seconds but at the cost of resolution, achieving only 0.7 ϫ 0.7 ϫ 0.8 mm.…”

Electrocochleography for Ménière's disease: is it reliable?

“…28 Seo et al also demonstrated endolymphatic hydrops in the cochlea (81%) and saccule (69%) using MRI 3 T after intratympanic gadolinium in correlation with abnormal electrocochleographic thresholds. They considered as an altered SP/AP threshold for click stimuli greater than 0.33, and 1000 Hz tonebursts were considered abnormal if the absolute magnitude of PS were ≤3 V. 29 Studies examined the difference in specificity and sensitivity of transtympanic and extratympanic collection methods. The present review demonstrated that the transtympanic method would be more effective; however, according to Pappas, Ghosh, and Chung, the extratympanic method can also be considered as an effective, easy to perform in clinical practice, and non-invasive method.…”