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Two observers assessed 14 MRI descriptors. \u201cDefinite MD\u201d (2015 criteria) and \u201call MD\u201d ears (wider clinical criteria) were compared to controls. Cohen\u2019s kappa and risk ratios (RR) were evaluated for each descriptor. Forward stepwise logistic regression established which combination of descriptors best predicted MD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The study included 132 patients (57 men; mean age 57.7\u2009\u00b1\u200913.6), with 87 \u201call MD\u201d (56 \u201cdefinite\u201d) and 39 control ears. The NSE sequence demonstrated increased perilymph SNR, and improved both diagnostic performance and reliability for 9\/14 descriptors. However, ZPE demonstrated superior diagnostic performance for the best descriptor of \u201csaccule absent, large as or confluent with the utricle\u201d (RR 6.571, ZPE; 6.300, NSE) and that of \u201casymmetric perilymphatic enhancement\u201d (RR 3.628, ZPE; 2.903, NSE). Both sequences combined these two descriptors in the optimal predictive model for \u201cdefinite MD\u201d, with \u201cgrade 2 cochlear hydrops\u201d also significant for NSE. ZPE and NSE descriptor combinations both correctly classified 95.8% of ears. The ZPE descriptor combination performed better for \u201call MD\u201d (ZPE, AUC-ROC 0.914; NSE, AUC-ROC 0.893).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Parameter optimisation with NSE Real-IR influenced the optimal selection of MRI descriptors but did not improve their diagnostic performance in definite MD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Question<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Delayed post-gadolinium ZPE (FLAIR) and NSE (REAL-IR) sequences are widely applied for diagnosing MD, but their relative benefits remain unclear<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Findings<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Optimised NSE sequences improve perilymphatic depiction and influence the selection of the optimal MRI descriptors, but do not improve diagnostic performance<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Clinical relevance<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Radiologists may continue to apply either ZPE or NSE sequences since they offer similar diagnostic abilities, but the choice of the sequence will influence which MRI features should be evaluated to support the diagnosis of MD<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00330-024-11218-0","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T21:38:02Z","timestamp":1733261882000},"page":"1290-1302","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The impact of 3D real-IR delayed post gadolinium MRI parameterisation on the diagnostic performance and optimal descriptor selection in M\u00e9ni\u00e8re\u2019s disease"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5502-4972","authenticated-orcid":false,"given":"Steve","family":"Connor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irumee","family":"Pai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Touska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Price","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Ourselin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph V.","family":"Hajnal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"key":"11218_CR1","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1017\/S0022215100003947","volume":"53","author":"GS Hallpike","year":"1938","unstructured":"Hallpike GS, Cairns H (1938) Observations on the pathology of Meniere\u2019s syndrome. 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The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The 132-patient cohort in this study has an overlap with that applied to four previous studies. The hypothesis, data extracted, and analysis are however different. Thirty-one patients in ref. []. Twenty-two patients in ref. []. Thirty-five patients in ref. []. Ninety-eight patients in ref. [].","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}