The diagnostic significance and value of vestibular function testing combined with MRI in Meniere’s disease

This study aims to evaluate the diagnostic efficacy of electrocochleography (EcochG), vestibular evoked myogenic potentials (VEMPs), magnetic resonance imaging (MRI), and their combination in diagnosing Meniere’s disease (MD) by comparing these methods against established diagnostic standards. Using MRI as a reference for assessing the degree of endolymphatic hydrops (EH), this study analyzes the correlation between EH and each diagnostic method and assesses the ability of these methods to predict EH severity. A retrospective analysis was performed on 50 patients diagnosed with unilateral definite Meniere’s disease (DMD), which included functional vestibular examinations and MRI. All patients underwent testing for EcochG and VEMPs. The amplitudes of the summating potential (SP) and the cochlear nerve action potential (AP) were measured during the EcochG assessment. The VEMPs comprised cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP), with bilateral amplitude ratios recorded. Abnormal findings were defined as a summating potential to action potential (SP/AP) ratio of ≥ 40% and/or a bilateral amplitude ratio greater than 1.61. This study also assessed the diagnostic accuracy of EcochG, VEMPs, MRI, and combined examinations for diagnosing unilateral DMD, along with their association with EH. A total of 50 patients (100 ears) were examined using relevant diagnostic methods. The positivity rate of EcochG was significantly lower than that of the other diagnostic methods (P < 0.05). Taking into account sensitivity, specificity, and AUC values comprehensively, the combined accuracy of EcochG, VEMPs, and MRI was significantly higher than that of the other diagnostic methods (P < 0.05). Additionally, we found that EcochG was negatively correlated with EH, whereas cVEMP was positively correlated with EH. Although the combination of EcochG, VEMPs, and MRI demonstrates a lower positivity rate but higher specificity compared to other diagnostic test batteries, its overall diagnostic accuracy for diagnosing MD remains superior. Therefore, this combination holds significant diagnostic value in the evaluation of MD.