Imaging the Ménière's disease on 3T-MRI

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.