Introduction:
Menière's disease is one of the most common inner ear disorders with hearing loss
and vertigo. It's etiology and pathogenesis is still incompletely resolved, but the
endolymphatic hydrops (EH) has been recognized as the underlying pathomorphology.
At present, no audiovestibular function test exists to prove Menière disease. That
is why visualization of EH in vivo by MR imaging represents a significant clinical
progress.
Methods:
Since 2016, we examined over 30 patients 6 hours after contrast based routine MR Imaging
of the temporal bone with thin layer 3D inversion recovery sequence (15 min. scan
time) by what the endolymphatic space could indirectly be visualized.
Results:
With the presence of clinical symptoms of Menière's disease, EH on MRI and exclusion
of other causes of vertigo and hearing loss, it is possible to confirm the diagnosis
of definitve Menière's disease. This is an objective basis to make an informed decision
for therapy, and to evaluate the risk benefit especially in case with bilateral hydrops
and unilateral hearing loss.
Conclusion:
With this strategy it is possible to avoid disabeling long-term observation periods
in vestibular disorders and to improve the compliance of the patient. In our department
this procedure becomes of increasing importance as a diagnostic component for Menière's
disease which is regularly performed before medical or surgical ablative therapy.
