The Correlation Between Endolymphatic Hydrops Which Is Diagnosed By MRI With Gadolinium Contrast And Clinical Features Of Meniere’s Disease

Objective: The purpose of this study was to investigate the grades of endolymphatic hydrops determined by gadoliniumcontrast magnetic resonance(MR)and correlation to the clinical features in patients with Meniere disease.Materials and Methods: A total of 93 patients suffering from unilateral definite Meniere disease were included.The duration of vertigo,duration of tinnitus,duration of vertigo attacks,hearing thresholds,and canal paresis(CP)value of caloric tests were assessed by otolaryngologist.Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging(MRI)was performed 4 hours after intravenous injection of double dose of gadobutrol(Gd)to show endolymph and perilymph,and the grades of endolymphatic hydrops were measured.Cochlear endolymphatic quantitative value are represented by the ratio of the transverse diameter of the basal cochlear duct to the sum of the transverse diametres of cochlear duct and the scala vestibule of basal turn and scala tympani of second turn of cochlea;vestibular endolymphatic value are represented by the ratio of the area of the endolymphatic space to that of the sum of the endolymphatic and perilymphatic spaces.Additionally,the correlation between clinical features and the grades of endolymphatic hydrops of cochlea and vestibular were evaluated.Results: 93 patients underwent outpatient examination.The duration of vertigo was 2(0.950,4.250)years,the duration of tinnitus was 3(1,9)years,and the duration of vertigo attack was 2(1,7.25)hours;all patients had different degrees of hearing loss,the mean hearing level of low,middle and high tone was 55.946±16.692 d B,52.823±16.477 d B,65.511±18.784 d B,respectively.22 patients(23.7%)with semicircular canal paresis(CP value)< 25% in caloric tests,41 patients(44.1%)with CP≥25%,30 patients(32.2%)without examination,and the CP value of 63 patients was 38.234±25.952%.All patients showed different grades of endolymphatic hydrops in the affected ear by MRI.The mean quantitative value of cochlear endolymphatic hydrops was 0.470(0.294,0.562),and the mean quantitative value of vestibular endolymphatic hydrops was 0.485(0.325,0.595).Spearman correlation analysis showed that the correlation coefficients of duration of vertigo,duration of tinnitus,duration of vertigo attacks,low tone,middle tone,high tone,CP value and the grades of cochlear endolymphatic hydrops were 0.202,0.118,-0.071,0.589,0.482,0.053,0.064,and the correlation coefficients of vestibular endolymphatic hydrops were 0.195,0.129,0.001,0.530,0.532,0.133,-0.079,respectively.There was significant correlation between low and middle tone hearing loss and the grades of endolymphatic hydrops in cochlea and vestibule(P<0.05).There were no significant correlation between other clinical features and endolymphatic hydrops(P>0.05).Conclusion: By visualizing the endolymph and perilymph of inner ear in patients with Meniere disease assisted with intravenous injection of double doses of Gd,the grades of endolymphatic hydrops could be assessed.In addition,the grades of endolymphatic hydrops can be estimated clinically according to the degree of low and middle tone hearing loss in Meniere’s disease.