European Radiology

, Volume 28, Issue 7, pp 2916–2922 | Cite as

In vivo imaging of saccular hydrops in humans reflects sensorineural hearing loss rather than Meniere’s disease symptoms

  • Arnaud Attyé
  • Michael Eliezer
  • Maud Medici
  • Irène Tropres
  • Georges Dumas
  • Alexandre Krainik
  • Sébastien Schmerber
Head and Neck



A case-controlled imaging study demonstrated that saccular hydrops was specific to Meniere’s disease (MD), but only present in a subset of patients. Here, we compared patients with definite MD, vertigo and sensorineural hearing loss (SNHL) to elucidate the relationship between saccular hydrops and extent of SNHL.


In this prospective study, we performed 3D-FLAIR sequences between 4.5 and 5.5 h after contrast media injection in patients with MD (n=20), SNHL (n=20), vertigo (n=20) and 30 healthy subjects. Two radiologists independently graded saccular hydrops. ROC analysis was performed to determine the hearing loss threshold to differentiate patients with saccular hydrops.


Saccular hydrops was found in 11 of 20 MD patients, 10 of 20 SNHL patients and in none of the vertigo patients and healthy subjects. In SNHL patients, 45 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 90 %. In MD patients, 40 dB was the threshold above which there was a significant association with saccular hydrops, with sensitivity of 100 % and specificity of 44 %.


Our results indicate saccular hydrops as a feature of worse than moderate SNHL rather than MD itself.

Key Points

MRI helps clinicians to assess patients with isolated low-tone sensorineural hearing loss.

Saccular hydrops correlates with sensorineural hearing loss at levels above 40 dB.

Vertigo patients without sensorineural hearing loss do not have saccular hydrops.

Saccular hydrops is described in patients without clinical diagnosis of Meniere’s disease.


Inner ear Meniere’s disease Magnetic resonance imaging Endolymphatic hydrops Hearing loss 



Endolymphatic sac surgery


Meniere’s disease


Sensorineural hearing loss


Saccule to Utricle Ratio Inversion



The authors acknowledge the valuable assistance of Patrice Jousse and Hélène Fournié for their work in editing the MRI pictures and drawings. We also thank Dr Alison Foote (Grenoble Alps University Hospital) for critically reviewing the manuscript.


IRMaGe MRI/Neurophysiology facility was partly funded by the French program “Investissement d’Avenir” run by the “Agence Nationale pour la Recherche”; grant “Infrastructure d’avenir en Biologie Santé” - ANR-11-INBS-0006. This study was also partly funded by Guerbet SA for MRI in healthy volunteers.

Compliance with ethical standards


The scientific guarantor of this publication is Arnaud Attyé.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Maud Medici) has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study healthy subjects have been previously reported in European Radiology (


• prospective

• case-control study

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Neuroradiology and MRIGrenoble Alpes University Hospital – SFR RMN NeurosciencesGrenobleFrance
  2. 2.IRMaGeUniversity Grenoble AlpesGrenobleFrance
  3. 3.Neuroradiology and MR UnitCS 10217- Grenoble University HospitalGrenoble cedex 9France
  4. 4.Department of RadiologyRouen University HospitalRouenFrance
  5. 5.Unité innovation technologique, Centre d’Investigation CliniqueCHU de Grenoble, CS 10217Grenoble cedex 9France
  6. 6.IRMaGe, Inserm US 17, CNRS UMS 3552GrenobleFrance
  7. 7.Department of OtologyGrenoble Alpes University HospitalGrenobleFrance

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