Differentiation of patients with Ménière's disease from vestibular migraine: perspective of two types of MRI-based indices.

BACKGROUND

Differentiating Ménière's disease (MD) from vestibular migraine (VM) is clinically significant.

OBJECTIVE

We aimed to compare the diagnostic performance of two MRI parameters, endolymphatic hydrops (ELH) and endolymphatic drainage system, in distinguishing MD from VM and to explore their correlations.

MATERIAL AND

METHODS

Fifty-five MD and 34 VM patients underwent 3D-FLAIR sequences after intratympanic gadolinium injection. ELH was evaluated with Nakashima criteria, and endolymphatic drainage system parameters, including the distance between the vertical part of the posterior semicircular canal and the posterior fossa (MRI-PPD) and the vestibular aqueduct (MRI-VA) visibility, were assessed.

RESULTS

(1) MD patients had higher cochlear and vestibular ELH grades and vestibular ELH ratio on the affected side compared to VM patients. MD patients showed bilaterally reduced MRI-VA visibility compared to VM patients. (2) Higher cochlear and vestibular ELH grades were associated with reduced MRI-VA visibility, and increased cochlear ELH grade correlated with shorter PPD.

CONCLUSIONS AND SIGNIFICANCE: MRI-VA invisibility and short PPD, may be interrelated features of inner ear ELH in vivo. Moreover, the bilaterally symmetrical reduction of VA visibility may be a potential biomarker in differentiating MD from VM, with comparable efficiency as that of ELH.