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DOI: 10.1055/s-0041-1728476
Importance of MRI with hydrops imaging in clinical practice of diagnosis of Menière’s disease
Menière’s disease is one of the most frequent peripheral vestibular diseases. Due to vertigo attacks and longtime progression, it represents a significant burden for patients. Based on clinical criteria alone, a clear differentiation between other peripheral and central vestibular diseases is not always possible. Since 2016, we examined 100 patients with clinically definite or probable Menière’s disease (Bárány classification)[1] who reported actual or recurrent symptoms (with or without drug treatment).A contrast-agent-based temporal bone MRI (double gadolinium dose and 3D-inversion-recovery-sequence) was conducted, followed by a 3T MRI 6 hours later.Grading of endolymphatic hydrops was set according to the classification of Baráth et al. [2]with none, grade I or grade II hydrops.The majority of patients showed clinical symptoms of a definite Menière’s disease. Approximately 2/3 of these patients, an endolymphatic hydrops grade I or grade II (one side or both sides) was radiologically identified.Approximately 1/3 did not show hydrops. Due to recurrent vertigo symptoms, an interventional drug therapy or surgical therapy was conducted in approximately 1/3 of the patients with confirmation of endolymphatic hydrops by means of MRI. In our opinion, in all patients with clinically definite Menière’s disease and confirmed endolymphatic hydrops grade I or grade II, a better understanding of disease could be achieved leading to an early therapy induction respecting our standardized treatment scheme [3]. Based on our experiences, MRI with hydrops sequence is useful in patients with Menière’s disease symptoms before invasive or ablative therapeutic measures to exclude other reasons or a two-sided hydrops.
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Publication History
Article published online:
13 May 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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