{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:58:51Z","timestamp":1792803531106,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1119","license":[{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives:<\/jats:title>\n                  <jats:p>Delayed post-gadolinium 3D fluid-attenuated inversion recovery (FLAIR) MRI is used to support a diagnosis of M\u00e9ni\u00e8re\u2019s disease (MD) with the ratio of the endolymphatic space (ES) to the sum of the endolymphatic and perilymphatic spaces (SEPS) on a cross-section through the vestibule being a key diagnostic criterion. It was hypothesised that the exact definition of the vestibular cross-section would influence the ES: SEPS ratio, its ability to diagnose MD, and its reproducibility.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>Following institutional approval, 22 patients (five male, 17 female; mean age 52.1) with unilateral MD and delayed post-gadolinium 3D FLAIR MRI were retrospectively analysed. Two observers measured the ES and SEPS on predefined axial (superior and inferior) and sagittal vestibular cross-sections. Receiver operating characteristic (ROC) curves, Bland-Altman plots and intraclass correlation (ICC) were analysed for the ES:SEPS ratios.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>The area under the curve (AUC) was decreased for the ES:SEPS ratios on the superior axial section through the vestibule (AUC 0.737) compared to the inferior axial (AUC 0.874) and sagittal sections (AUC 0.878). The resulting optimal thresholds (sensitivities\/specificities) were 0.21 (0.66\/0.75), 0.16 (0.77\/0.9) and 0.285 (0.75\/0.96). The reproducibility was excellent for all measures with ICCs of 0.97, 0.98 and 0.99.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>Inferior axial or sagittal vestibular cross-sections are more accurate for the diagnosis of MD ears and have excellent reproducibility.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>The choice of vestibular cross-section influences both the ability to distinguish MD from asymptomatic contralateral ears, and the optimum threshold ES:SEPS value.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20200996","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T18:42:52Z","timestamp":1610736172000},"source":"Crossref","is-referenced-by-count":5,"title":["Which is the optimally defined vestibular cross-section to diagnose unilateral Meniere\u2019s disease with delayed post-gadolinium 3D fluid-attenuated inversion recovery MRI?"],"prefix":"10.1093","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5502-4972","authenticated-orcid":false,"given":"Steve","family":"Connor","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering & Imaging Sciences Clinical Academic Group, King\u2019s College London , London , UK"},{"name":"Department of Radiology, Guy\u2019s and St Thomas\u2019 Hospital , London , UK"},{"name":"Neuroradiology Department, King's College Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Hulley","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medway Maritime Hospital, Kent , Gillingham , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Burd","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guy\u2019s and St Thomas\u2019 Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikul","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery, Guy\u2019s and St Thomas\u2019 Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irumee","family":"Pai","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering & Imaging Sciences Clinical Academic Group, King\u2019s College London , London , UK"},{"name":"Department of Ear, Nose and Throat Surgery, Guy\u2019s and St Thomas\u2019 Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"key":"2024050215251387800_b1","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1097\/MAO.0b013e31829e83df","article-title":"Endolymphatic hydrops in M\u00e9ni\u00e8re's disease: cause, consequence, or epiphenomenon?","volume":"34","author":"Foster","year":"2013","journal-title":"Otol Neurotol"},{"key":"2024050215251387800_b2","first-page":"2","article-title":"Meniere\u2019s disease and endolymphatic hydrops: clinical-histopathological correlations","volume":"89","author":"Fraysse","year":"1980","journal-title":"Rhinol Laryngol Suppl"},{"key":"2024050215251387800_b3","first-page":"1317","article-title":"Observations on the pathology of Meniere\u2019s syndrome","volume":"31","author":"Hallpike","year":"1938","journal-title":"Proc R Soc Med"},{"key":"2024050215251387800_b4","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2012-001555","article-title":"M\u00e9ni\u00e8re\u2019s disease: a reappraisal supported by a variable latency of symptoms and the MRI visualisation of endolymphatic hydrops","volume":"3","author":"Pyykk\u00f6","year":"2013","journal-title":"BMJ Open"},{"key":"2024050215251387800_b5","doi-asserted-by":"crossref","first-page":"3138","DOI":"10.1007\/s00330-016-4701-z","article-title":"Mri of endolymphatic hydrops in patients with Meniere's disease: a case-controlled study with a simplified classification based on saccular morphology","volume":"27","author":"Atty\u00e9","year":"2017","journal-title":"Eur Radiol"},{"key":"2024050215251387800_b6","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.3174\/ajnr.A3856","article-title":"Detection and grading of endolymphatic hydrops in Meni\u00e8re disease using MR imaging","volume":"35","author":"Bar\u00e1th","year":"2014","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024050215251387800_b7","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1007\/s00330-008-0854-8","article-title":"Separate visualization of endolymphatic space, perilymphatic space and bone by a single pulse sequence; 3D-inversion recovery imaging utilizing real reconstruction after intratympanic Gd-DTPA administration at 3 tesla","volume":"18","author":"Naganawa","year":"2008","journal-title":"Eur Radiol"},{"issue":"2-3","key":"2024050215251387800_b8","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3233\/VES-180646","article-title":"Systematic review of magnetic resonance imaging for diagnosis of Meniere disease","volume":"29","author":"Lopez-Escamez","year":"2009","journal-title":"VES"},{"key":"2024050215251387800_b9","doi-asserted-by":"crossref","first-page":"247","DOI":"10.3109\/00016489.2010.524938","article-title":"Noninvasive evaluation of endolymphatic space in healthy volunteers using magnetic resonance imaging","volume":"131","author":"Liu","year":"2011","journal-title":"Acta Otolaryngol"},{"key":"2024050215251387800_b10","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ejrad.2018.10.023","article-title":"Three-Tesla magnetic resonance imaging of the vestibular endolymphatic space: a systematic qualitative description in healthy ears","volume":"109","author":"Conte","year":"2018","journal-title":"Eur J Radiol"},{"issue":"sup560","key":"2024050215251387800_b11","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/00016480902729827","article-title":"Grading of endolymphatic hydrops using magnetic resonance imaging","volume":"129","author":"Nakashima","year":"2009","journal-title":"Acta Otolaryngol Suppl"},{"key":"2024050215251387800_b12","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.clinimag.2014.09.014","article-title":"Delayed intravenous contrast-enhanced 3D FLAIR MRI in Meniere's disease: correlation of quantitative measures of endolymphatic hydrops with hearing","volume":"39","author":"Sepahdari","year":"2015","journal-title":"Clin Imaging"},{"key":"2024050215251387800_b13","doi-asserted-by":"crossref","first-page":"529","DOI":"10.3174\/ajnr.A6410","article-title":"Value of endolymphatic hydrops and perilymph signal intensity in suspected M\u00e9ni\u00e8re disease","volume":"41","author":"van Steekelenburg","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024050215251387800_b14","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1186\/1471-2105-9-265","article-title":"StAR: a simple tool for the statistical comparison of ROC curves","volume":"9","author":"Vergara","year":"2008","journal-title":"BMC Bioinformatics"},{"key":"2024050215251387800_b15","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s00330-014-3414-4","article-title":"MR volumetric assessment of endolymphatic hydrops","volume":"25","author":"G\u00fcrkov","year":"2015","journal-title":"Eur Radiol"},{"key":"2024050215251387800_b16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0120357","article-title":"Semi-Quantitative vs. volumetric determination of endolymphatic space in Meni\u00e8re's disease using endolymphatic hydrops 3T-HR-MRI after intravenous gadolinium injection","volume":"10","author":"Homann","year":"2015","journal-title":"PLoS One"},{"key":"2024050215251387800_b17","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1017\/S0022215112000060","article-title":"A new magnetic resonance imaging scoring system for perilymphatic space appearance after intratympanic gadolinium injection, and its clinical application","volume":"126","author":"Fang","year":"2012","journal-title":"J Laryngol Otol"},{"key":"2024050215251387800_b18","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1097\/MAO.0b013e318268d087","article-title":"Herniation of the membranous labyrinth into the horizontal semicircular canal is correlated with impaired caloric response in M\u00e9ni\u00e8re's disease","volume":"33","author":"G\u00fcrkov","year":"2012","journal-title":"Otol Neurotol"},{"key":"2024050215251387800_b19","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.3174\/ajnr.A5841","article-title":"Mr imaging in Meni\u00e8re disease: is the contact between the vestibular endolymphatic space and the oval window a reliable biomarker?","volume":"39","author":"Conte","year":"2018","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024050215251387800_b20","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s00234-019-02155-7","article-title":"The value of four stage vestibular hydrops grading and asymmetric perilymphatic enhancement in the diagnosis of Meni\u00e8re's disease on MRI","volume":"61","author":"Bernaerts","year":"2019","journal-title":"Neuroradiology"},{"key":"2024050215251387800_b21","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1097\/MAO.0b013e31825d9a95","article-title":"In vivo visualized endolymphatic hydrops and inner ear functions in patients with electrocochleographically confirmed M\u00e9ni\u00e8re's disease","volume":"33","author":"G\u00fcrkov","year":"2012","journal-title":"Otol Neurotol"},{"key":"2024050215251387800_b22","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1288\/00005537-199303000-00007","article-title":"Symptomatic versus asymptomatic endolymphatic hydrops: a histopathologic comparison","volume":"103","author":"Sperling","year":"1993","journal-title":"Laryngoscope"},{"key":"2024050215251387800_b23","doi-asserted-by":"crossref","first-page":"369","DOI":"10.14639\/0392-100X-1986","article-title":"MR imaging of endolymphatic hydrops in Meniere\u2019s disease: not all that glitters is gold","volume":"38","author":"Conte","year":"2018","journal-title":"Acta Ororhinolaryngol Ital"},{"key":"2024050215251387800_b24","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s11604-014-0290-4","article-title":"Visualization of endolymphatic hydrops with MR imaging in patients with M\u00e9ni\u00e8re's disease and related pathologies: current status of its methods and clinical significance","volume":"32","author":"Naganawa","year":"2014","journal-title":"Jpn J Radiol"},{"key":"2024050215251387800_b25","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1177\/000348948909801108","article-title":"Meniere's syndrome and endolymphatic hydrops. double-blind temporal bone study","volume":"98","author":"Rauch","year":"1989","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"2024050215251387800_b26","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/BF00173659","article-title":"Blockage of longitudinal flow in endolymphatic hydrops","volume":"248","author":"Schuknecht","year":"1991","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2024050215251387800_b27","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.neurad.2017.06.002","article-title":"Influence of inversion time on endolymphatic hydrops evaluation in 3D-FLAIR imaging","volume":"44","author":"Eliezer","year":"2017","journal-title":"J Neuroradiol"},{"key":"2024050215251387800_b28","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1097\/MAO.0b013e31826426b9","article-title":"Characteristics of Patients With Unilateral and Bilateral M\u00e9ni\u00e8re\u2019s Disease","volume":"33","author":"Clemmens","year":"2012","journal-title":"Otology & Neurotology"},{"key":"2024050215251387800_b29","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1017\/S0022215120000626","article-title":"Magnetic resonance imaging of M\u00e9ni\u00e8re's disease: early clinical experience in a UK centre","volume":"134","author":"Pai","year":"2020","journal-title":"J Laryngol Otol"}],"container-title":["The British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/94\/1119\/20200996\/57376264\/bjr.20200996.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/94\/1119\/20200996\/57376264\/bjr.20200996.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T16:49:28Z","timestamp":1714668568000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/doi\/10.1259\/bjr.20200996\/7451669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,15]]},"references-count":29,"journal-issue":{"issue":"1119","published-online":{"date-parts":[[2021,1,15]]},"published-print":{"date-parts":[[2021,3,1]]}},"URL":"https:\/\/doi.org\/10.1259\/bjr.20200996","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2021,1,15]]},"article-number":"20200996"}}