Value of Endolymphatic Hydrops and Perilymph Signal Intensity in Suspected Ménière Disease

BACKGROUND AND PURPOSE: Meniere disease is characterized by endolymphatic hydrops, whereas perilymphatic enhancement on MR imaging has been suggested to be of additional value in diagnosing Meniere disease. This study evaluates the presence of endolymphatic hydrops and perilymphatic enhancement in patients with Meniere disease and with other vertigo-associated inner ear pathology. MATERIALS AND METHODS: A 3D-FLAIR sequence 4 hours after intravenous gadolinium injection was performed to visualize the endolymph and perilymph in 220 patients suspected of having Meniere disease. Patients’ ears were retrospectively categorized as having Meniere disease (probable or definite) or other vertigo-associated inner ear pathology not attributable to Meniere disease. Endolymphatic hydrops was evaluated using a visual classification system, and perilymphatic enhancement was scored both visually and quantitatively. RESULTS: Endolymphatic hydrops was present in 137 (91.9%) of the definite Meniere disease ears and in 9 (7.0%) of the ears with other vertigo-associated inner ear pathology (P CONCLUSIONS: The combination of perilymphatic enhancement and endolymphatic hydrops in patients suspected of having Meniere disease increases the positive predictive value in the diagnosis of definite Meniere disease.