Combination of cochlear endolymphatic hydrops and vestibular endolymphatic hydrops achieves 100 percent diagnostic accuracy
By Elana Gotkine HealthDay Reporter
MONDAY, June 23, 2025 (HealthDay News) — The combination of cochlear endolymphatic hydrops (CEH) and vestibular endolymphatic hydrops (VEH) on magnetic resonance imaging (MRI) accurately diagnoses Meniere disease (MD) and vestibular migraine (VM), according to a study published online May 13 in Frontiers in Neurology.
Anja Bernaerts, M.D., from ZAS Hospitals in Antwerp, Belgium, and colleagues conducted a prospective study involving 31 patients who underwent MRI: (15 with MD or probable MD and 16 with VM or probable VM) to examine the effectiveness of delayed postgadolinium three-dimensional sampling perfection with application-optimized contrasts using different flip angle evolution fluid-attenuated inversion recovery sequence to differentiate between MD and VM.
The researchers found that none of the patients with VM showed signs of CEH, VEH, or increased perilymphatic enhancement (PLE). Only two patients had normal CEH, one had normal VEH, and six had equal PLE in both ears in the MD group. Using both CEH and VEH, the logistic regression analysis correctly predicted all cases of MD and VM; 100 percent diagnostic accuracy was achieved for both of the conditions. Misclassifications resulted from use of only CEH, VEH, or PLE as diagnostic criteria; two, one, and six patients were incorrectly classified as having VM based on CEH, VEH, and PLE, respectively.
“We conclude that, since CEH, VEH, and asymmetrical PLE are not found in VM patients, hydrops MRI can effectively facilitate the differential diagnosis between VM and MD when applied in the appropriate clinical setting,” the authors write.
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