{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:13:44Z","timestamp":1792026824063,"version":"4.4.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We investigated the effectiveness of delayed post-gadolinium (Gd) three-dimensional (3D) sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) fluid-attenuated inversion recovery (FLAIR) sequence to differentiate between Meni\u00e8re\u2019s disease (MD) and vestibular migraine (VM) in a prospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 31 patients\u201415 with MD (10 with definite MD and 5 with probable MD) and 16 with VM (9 with definite VM, 7 with probable VM)\u2014were prospectively enrolled between January 2019 and December 2022. The female-to-male ratio in the MD group was 7:8, while in the VM group, it was 14:2. All patients underwent a 3D SPACE FLAIR sequence and a 3D SPACE T2 sequence 4\u202fh after intravenous (IV) injection of a single dose of gadobutrol (1.0\u202fmmoL\/mL). Cochlear endolymphatic hydrops (CEH), vestibular endolymphatic hydrops (VEH), and asymmetrical perilymphatic enhancement (PLE) were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>None of the VM patients showed signs of CEH, VEH, or increased PLE. However, in the MD group, only two patients had normal CEH, one patient had normal VEH, and six patients demonstrated equal PLE in both ears. The logistic regression analysis using both VEH and CEH correctly predicted all cases of MD and VM, achieving 100% diagnostic accuracy for both conditions. However, using only CEH, VEH, or PLE as diagnostic criteria resulted in misclassifications: two patients were incorrectly classified as having VM based on CEH, one based on VEH, and six based on PLE. These results highlight the superior diagnostic power of the combination of CEH and VEH in logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of CEH and VEH allows for 100% accurate identification of VM and MD. This approach facilitates a reliable differential diagnosis of MD and VM when used in the appropriate clinical setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical relevance statement<\/jats:title><jats:p>This study demonstrates that hydrops magnetic resonance imaging (MRI) can accurately differentiate MD from VM. Therefore, hydrops MRI can obviate the need for trial medication in cases with clinically ambiguous findings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1582754","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:12:43Z","timestamp":1747195963000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Role of hydrops MRI in differentiating between Meni\u00e8re\u2019s disease and vestibular migraine: a prospective study"],"prefix":"10.3389","volume":"16","author":[{"given":"Anja","family":"Bernaerts","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgana","family":"Sluydts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Li\u00e9geois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Blaivie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris L.","family":"Wuyts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"van Dinther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Zarowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Deckers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert","family":"De Foer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"16028","DOI":"10.1038\/nrdp.2016.28","article-title":"Meni\u00e8re\u2019s disease","volume":"2","author":"Nakashima","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3233\/VES-150549","article-title":"Classification committee of the Barany society; Japan Society for Equilibrium Research, European academy of otology and Neurotology (EAONO); equilibrium Committee of the American Academy of otolaryngology -head and neck surgery (AAO-HNS); Korean balance society \u2018diagnostic criteria for Meni\u00e8re\u2019s disease\u2019","volume":"25","author":"Lopez-Escamez","year":"2015","journal-title":"J Vestib Res"},{"key":"ref3","doi-asserted-by":"publisher","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\u2019s disease and related pathologies: current status of its methods and clinical significance","volume":"32","author":"Naganawa","year":"2014","journal-title":"Jpn J Radiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1007\/s00234-021-02744-5","article-title":"Magnetic Resonance and Meni\u00e8re\u2019s disease-unavoidable alliance","volume":"63","author":"Sousa","year":"2021","journal-title":"Neuroradiology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1007\/s00234-022-02913-0","article-title":"Comparison between 3D SPACE FLAIR and 3D TSE FLAIR in Meni\u00e8re\u2019s disease","volume":"64","author":"Bernaerts","year":"2022","journal-title":"Neuroradiology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1080\/00016489.2020.1792550","article-title":"Comparison between high-resolution 3D-IR with real reconstruction and 3D-FLAIR sequences in the assessment of endolymphatic hydrops in 3 tesla","volume":"140","author":"Su\u00e1rez-Vega","year":"2020","journal-title":"Acta Otolaryngol"},{"key":"ref7","doi-asserted-by":"publisher","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 Meniere\u2019s disease on MRI","volume":"61","author":"Bernaerts","year":"2019","journal-title":"Neuroradiology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"7113","DOI":"10.1007\/s00330-023-09651-8","article-title":"Delayed post gadolinium MRI descriptors for Meniere\u2019s disease: a systematic review and meta-analysis","volume":"33","author":"Connor","year":"2023","journal-title":"Eur Radiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"167","DOI":"10.3233\/VES-2012-0453","article-title":"Vestibular migraine: diagnostic criteria","volume":"22","author":"Lempert","year":"2012","journal-title":"J Vestibul Res"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1007\/s00405-021-06716-6","article-title":"Recurrent vestibulopathy: are cVEMP, oVEMP and inner ear MRI useful to distinguish patients with Meni\u00e8re\u2019s disease and vestibular migraine?","volume":"279","author":"Eliezer","year":"2022","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2661","DOI":"10.1007\/s00405-013-2751-2","article-title":"Endolymphatic hydrops in patients with vestibular migraine and auditory symptoms","volume":"271","author":"G\u00fcrkov","year":"2014","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"529","DOI":"10.3174\/ajnr.A6410","article-title":"Value of endolymphatic hydrops and perilymph signal intensity in suspected M\u00e9ni\u00e8re\u2019s disease","volume":"41","author":"Van Steekelenburg","year":"2020","journal-title":"Am J Neuroradiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"21527","DOI":"10.1038\/s41598-023-49066-5","article-title":"MRI can help differentiate M\u00e9ni\u00e8re\u2019s disease from other menieriform diseases","volume":"13","author":"Li","year":"2023","journal-title":"Sci Rep"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1136\/jnnp-2024-334419","article-title":"Imaging endolymphatic space of the inner ear in vestibular migraine","volume":"96","author":"Kirsch","year":"2024","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e1312","DOI":"10.1002\/lio2.1312","article-title":"Perilymphatic enhancement and endolymphatic hydrops: MRI findings and clinical associations","volume":"9","author":"Kobayashi","year":"2024","journal-title":"Laryngoscope Investig Otolaryngol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1582754\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:12:44Z","timestamp":1747195964000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1582754\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,14]]},"references-count":15,"alternative-id":["10.3389\/fneur.2025.1582754"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1582754","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,14]]},"article-number":"1582754"}}