AUTHOR=Diorflar Sarah , Guigou Caroline , Daguet Edouard , Bensimon Jean-Loup , Toupet Michel , Bozorg-Grayeli Alexis 

TITLE=Confrontation of endolymphatic hydrops diagnosis on 3-Tesla MRI to clinical and audiovestibular findings in Meniere's disease

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1105461

DOI=10.3389/fneur.2023.1105461

ISSN=1664-2295

ABSTRACT=<sec><title>Objective</title><p>The aim of this study was to compare different MRI diagnostic criteria for endolymphatic hydrops (EH) and to investigate the relation between audiovestibular and MRI findings in Meniere's disease (MD).</p></sec><sec><title>Materials and methods</title><p>Prospective cross-sectional cohort study in 2 referral centers included 76 patients with unilateral (<italic>n</italic> = 62) or bilateral (<italic>n</italic> = 14) MD. All patients underwent inner ear 3T-MRI 4 h (<italic>n</italic> = 52) or &gt;24H (<italic>n</italic> = 24) following audiovestibular tests. T2-CISS and 3D-FLAIR images 4H after gadolinium were obtained. EH diagnosis was based on saccular morphology on coronal views (T2 and 3D-FLAIR), semi quantitative estimation of endolymphatic space enlargement, and saccule utricle ratio inversion (SURI) on 3D-FLAIR axial views.</p></sec><sec><title>Results</title><p>SURI was the best criterion related to the disease side (43 SURI+ on symptomatic ears, <italic>n</italic> = 77, <italic>vs</italic>. 6 SURI+ on asymptomatic ears, <italic>n</italic> = 53, <italic>p</italic> &lt; 0.0001, Chi-2). Same-day MRI revealed relation between EH, hearing loss and caloric weakness which could not be detected on delayed MRI: SURI was associated with a higher pure-tone average (43 ± 4.1 dB in SURI+ ears, <italic>n</italic> = 42 <italic>vs</italic>. 23 ± 2.6 SURI-, <italic>n</italic> = 62, <italic>p</italic> &lt; 0.0001, unpaired t-test,), and a higher proportion of vestibular caloric weakness (23/46 SURI+ ears <italic>vs</italic>. 4/62 SURI-, <italic>p</italic> &lt; 0.001, Chi-2). Among all criteria, SURI combined to caloric weakness was the best predictor of the affected side in a logistic regression model.</p></sec><sec><title>Conclusion</title><p>SURI had the strongest relation to the side the disease and audio vestibular findings for unilateral, probable and definite meniere disease. A short delay between MRI and audio vestibular tests improved the coherence between the findings.</p></sec>