Delayed contrast MRI for the evaluation of Ménière's disease: an Australian perspective.

Abstract

Objectives: Ménière's disease is a chronic inner-ear disease attributed to endolymphatic hydrops. Magnetic resonance imaging with gadolinium allows visualisation of endolymphatic hydrops in vivo and may be an adjunct to diagnosis.

Methods: Thirty-eight patients suspected of having Ménière's disease underwent T2 weighted three-dimensional fluid-attenuated inversion recovery and true inversion recovery sequence magnetic resonance imaging 4 hours post double-dose intra-venous gadolinium. Presence of endolymphatic hydrops was graded by two radiologists at 0 and 4 months. Correlation to clinical diagnosis was assessed using Fisher's exact test.

Results: Hydrops was identified in 88 per cent, 17 per cent and 27 per cent of patients with Definite Ménière's, Probable Ménière's and Undifferentiated disease, respectively. A significant correlation existed between diagnosis and presence of hydrops. Sensitivity and specificity were 88 per cent and 67 per cent, respectively. Intra- and inter-observer agreement for presence and grading of hydrops was near-perfect and substantial to near-perfect, respectively.

Conclusion: Magnetic resonance imaging demonstrates radiographic hydrops with significant correlation to clinical diagnosis and good intra- and inter-observer agreement.