Endolymphatic Hydrops (EH) on MRI

EH is the distension of the endolymphatic space of the inner ears and is considered the hallmark of Menière's disease.
Delayed postcontrast imaging (optimized 3D-FLAIR):
Gd reachs the perilymph but not the endolymph
EH MRI Protocol
Cochlear EH Grading
Vestibular EH Grading
Tip 1: read the 3D-FLAIR sequence together with a heavily T2-weighted sequence to help differentiate the EH (arrows) and the surrounding bone.
Tip 2: be aware of the expected regions that accumulate Gd after 4h of IV injection. #NeuroRad #hnrad #otolaryngology

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