Predicting positive cochlear endolymphatic hydrops on magnetic resonance images

OBJECTIVE/HYPOTHESIS: This study correlated audiological results with magnetic resonance (MR) images to predict positive cochlear endolymphatic hydrops (EH) on MR images in patients with Meniere's disease (MD). STUDY DESIGN: Retrospective study. METHODS: Twenty definite MD patients with positive cochlear EH on MR images were assigned to Group A. Another 20 definite MD patients with negative cochlear EH on MR images were assigned to Group B. All patients underwent an inner ear test battery followed by MR imaging using HRDROPS‐Mi2 technique. RESULTS: The mean hearing levels (MHLs) at frequencies of 125, 250, 500 and 1000 Hz revealed significantly worse in Group A than Group B. Significantly deteriorated MHLs were noted from Grades 0 to II at low frequency (125, 250, and 500 Hz), but not at mid‐frequency and high frequency. The respective cutoff hearing thresholds at frequencies of 125, 250, and 500 Hz were 27.5, 32.5, and 40 dBHL, which help predict positive cochlear EH on MR images. By using the sum (27.5 + 32.5 + 40 = 100 dBHL) of cutoff thresholds from three low frequencies as a cutoff value, Group A (80%) showed significantly more ears with sum of low‐frequency hearing threshold >100 dBHL than Group B (30%). CONCLUSION: When sum of three low‐frequency (125, 250, and 500 Hz) hearing levels is >100 dBHL, positive cochlear EH may be shown on MR images in definite MD patients. In contrast, those MD patients with sum of three low‐frequency hearing levels <100 dBHL, MR imaging should be postponed because resolution of EH may cause negative MR images. Level of evidence: 4