Magnetic Resonance Imaging of Endolymphatic Hydrops Using Compressed Sensing Acceleration Technique

Endolymphatic hydrops (EH) is a key underlying pathologic alteration of Ménière's disease (MD). MD is characterized by recurrent episodes of spontaneous vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Magnetic resonance imaging (MRI) plays a crucial role in visualizing EH, with gadolinium-based contrast agents facilitating the identification of endolymph and perilymph. Specific MRI techniques, such as the hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) imaging method, offer high-quality results but are limited by long acquisition times. This study explores the use of compressed sensing to accelerate image acquisition and improve contrast-to-noise ratio (CNR) in EH imaging in a 3 Tesla magnet using a 16-channel array head coil, comparing a new proposed cs-HYDROPS sequence with the conventional HYDROPS technique. A total of 24 ears from 12 patients with suspected MD were analyzed using both methods. The cs-HYDROPS sequence demonstrated a substantial reduction in scan time with a significant reduction in acquisition time of 57.3% (from 30.2 minutes to 12.9 minutes) while achieving a 143.5% increase in CNR (mean CNR for cs-HYDROPS: 103.8; SD: 37.3). Diagnostic agreement between the two methods had a Cohen's kappa value of 0.903. These findings demonstrate that cs-HYDROPS offers a reliable and efficient alternative for evaluating EH in MD patients, reducing scan time while enhancing image quality and maintaining diagnostic accuracy. This technique may facilitate wider clinical adoption of EH imaging in the routine workup of MD.