Comparing the Saccule‐to‐Utricle Ratio in Early‐ Versus Late‐Stage Meniere's Disease Patients

Objective To compare the saccule‐to‐utricle ratio in early‐ versus late‐stage Meniere's disease (MD) patients based on magnetic resonance imaging (MRI) images. Methods In this retrospective study, we performed 3‐dimensional real inversion recovery (3D‐real IR) MRI 24 h after intratympanic gadolinium administration in unilateral MD patients at early‐stage ( n = 56) and late‐stage ( n = 70). Two radiologists independently graded endolymphatic hydrops (EH) and the saccule‐to‐utricle ratio inversion (SURI) was compared between the two groups. Furthermore, early‐stage MD patients were further divided into two subgroups based on disease duration: ≤6 months ( n = 20) and >6 months ( n = 36) and the SURI was compared. Results Among the 56 patients in the early‐stage group, 26 cases (46.43%) exhibited an enlarged saccule that is larger than the utricle, showing SURI. In contrast, among the late‐stage MD, only four cases (5.71%) showed SURI ( p < 0.001). In the early‐stage MD subgroup with a disease duration of ≤6 months, the proportion of SURI was 70% (14/20), which was higher than that in the subgroup with a disease duration of >6 months (33.33%, 12/36, p = 0.02). Conclusion SURI may serve as an effective imaging marker for diagnosis of early‐stage MD. Our finding suggests that endolymphatic hydrops in MD may primarily originate from the saccule. Level of Evidence Level 3 Laryngoscope , 2024