Purpose: The pathologic changes of Ménière's disease are known but still the reason remains
unclear why the endolymphatic hydrops of the inner ear builds up. Numerous theories
exist to enlighten how or why this occurs, but still they could not be proven. Purpose
was to visualize pathologic changes on patients with Ménière's disease.
Method and materials: We examined 14 patients with single sided Ménière's disease on a three tesla MRI.
Heavily T2 weighted images were used for calculation of maximum intensity projections
of the inner ear structures. High resolution T1 weighted images with and without contrast
agent were also performed to visualize inflammatory or neoplastic changes. T2 weighted
images were used to visualize possible changes of the differential diagnosis of acustic
neuroma.
Results: All of the 14 patients showed a clear contrast enhancement of the endolymphatic
sac on the affected side. The unaffected side showed no signal change after application
of contrast agent. Three dimensional reconstruction of the inner ear fluid showed
the entire inner ear permitting the visualization and diagnostic approach of structural
inner ear disorders.
Conclusion: Changes of the inner ear on patients with Ménière's disease can be visualized. Signal
enhancement of the endolymphatic sac assumes an inflammatory modification resulting
in a reduced resorption of inner ear fluid. This could be the cause of the inner ear
hydrops accused to provoke Ménière's disease.
