Visualization of Vestibular Aqueduct and Endolymphatic Hydrops in Meniere's Disease With <scp>3D</scp>‐Real <scp>IR</scp>

ABSTRACT Objectives To investigate the association between the vestibular aqueduct (VA) and endolymphatic hydrops (EH) in patients with Meniere's disease (MD) using three‐dimensional real inversion recovery (3D‐real IR) sequences. Methods This retrospective study included patients diagnosed with unilateral MD who underwent computed tomography (CT) and 3D‐real IR sequencing. The VA course was identified on CT, and its visibility was assessed using a 3D‐real IR sequence. The presence and severity of the cochlear and vestibular EH were evaluated. VA visualization was classified as Grade 0, whereas nonvisualization was classified as Grade 1. Differences in VA visibility between the affected and unaffected ears were compared, and correlations between VA visibility and EH severity were analyzed. Finally, the diagnostic efficacy of various MD indicators was assessed. Results A total of 56 patients with unilateral MD were analyzed. The incidence rates of cochlear or vestibular EH were higher in the affected ear group than in the unaffected ear group ( p &lt; 0.001). The rates of nonvisualization of the VA in the affected and unaffected ears were 91.1% and 41.1%, respectively, with a statistically significant difference ( χ 2 = 31.226, p &lt; 0.001). The VA visualization status was positively correlated with vestibular and cochlear EH ( p &lt; 0.001). The area under the curve for diagnosing MD using combined VA nonvisualization and EH was 0.876, which was significantly higher than that obtained using EH alone ( Z = 3.414, p = 0.001). Conclusion VA visibility on 3D‐real IR sequences may assist in the diagnosis of MD and associated EH. Level of Evidence 3