Meniere disease (MD) is an idiopathic inner ear disorder, and endolymphatic hydrops (EH) being considered to be its pathological basis. Currently, there is no gold standard for diagnosing MD. However, a recent study suggests that MRI by intratympanic gadolinium-based contrast media (GBCM) administration (IT-Gd) offers reliable radiological diagnostic criteria for MD. The study findings were published in the journal Scientific Reports on March 30, 2021.
A previous study has reported visualized EH using MRI by intratympanic gadolinium-based contrast media (GBCM) administration (IT-Gd) in patients with MD, and this technique was gradually established for MD diagnosis. However, few studies reported their diagnostic sensitivity and specificity in clinical application. Therefore, Dr Maoli Duan and his team conducted a study to investigate the clinical characteristics and magnetic resonance imaging (MRI) results of patients with MD and analyzing the relationship between clinical results and MRI findings in MD patients.
In this prospective study, researchers included a total of 117patients with definite MD. The diagnostic criteria were based on the latest guidelines revised in 2015. All the patients received IT-Gd 24 hours prior to MRI by injection through the tympanic membrane. All patients were followed at 1 week, 1, 3 and 6 months after the examination. The primary outcome assessed was diagnostic sensitivity and specificity of MRI findings.
Key findings of the study were:
Upon analysis, the researchers noted that the diagnostic sensitivity and specificity of MRI were 79.2% and 80.7% respectively.
However, they found no significant correlation between hearing levels and cochlear grading scores, nor vestibular grading scores.
They also found no significant association between duration of disease and cochlear or vestibular grading scores.
They noted 26 patients had false-negative MRI results and 21had false-positive MRI results.
Further, they reported no significant adverse reactions to IT-Gd injection, and all patients healed within one week.
The authors concluded, "Considering the high sensitivity and specificity, IT-Gd MRI offers reliable imaging diagnostic criteria for MD."
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DOI: https://doi.org/10.1038/s41598-021-86589-1