Observational study of inner ear contrast magnetic resonance images of endolymphatic hydrops to differentiate between definite and probable Menière's disease

Background: Endolymphatic hydrops has been associated with Menière's disease (MD), in vivo, using inner ear contrast magnetic resonance imaging (IEC-MRI). Objective: To evaluate the usefulness of identifying endolymphatic hydrops on IEC-MRI for the diagnosis of definite MD. Methods: Retrospective analysis of nine patients with MD who underwent audiometric assessment for sensorineural hearing loss in the low-to-medium frequency range and IEC-MRI at our clinic, between April 2020 and March 2022. The presence or absence of endolymphatic hydrops in the affected ear was determined. The sensitivity and specificity of endolymphatic hydrops to differentiate patients with probable and definite MD was calculated. Results: The study group included seven cases of definite MD and two cases of probable MD. Endolymphatic hydrops was observed on IEC-MRI in patients with definite (three of seven cases) but not probable MD. The specificity and positive predictive value of endolymphatic hydrops for definite MD were 100% each, with a sensitivity of 42.9%, and negative predictive value of 33.3%. The presence of endolymphatic hydrops was associated with a low-to-midrange hearing loss. Conclusions: Current methods of IEC-MRI have inadequate sensitivity for MD diagnosis. Future research is needed to improve methods of IEC-MRI to support its usefulness for MD diagnosis.