Contrast-enhanced magnetic resonance imaging in the diagnosis of Meniere’s disease: vague future or tangible reality?

Meniere's disease is characterized by vertigo, inconsistent hearing loss and progressive deterioration of audiological and vestibular functions. The attacks of Meniere's disease occur without obvious triggers and disrupt social adaptation of patients. Radiation diagnostic methods have not been included into the list of diagnostic criteria by the European Consensus on Diagnosis and Management of Meniere's disease (2018). However, a  number of studies have been published recently that indicate the feasibility of in vivo anatomical identification of endolymphatic hydrops, as the main disease substrate seen using contrast-enhanced magnetic resonance imaging. Due to the progress in radiological visualization of the inner ear, some patterns have been identified and new data obtained for Meniere's disease. The choice of the best route for contrast administration (intratympanic or intravenous) is a matter of active debate. There is no consensus on the criteria for the assessment of hydrops' grade. Future developments of the technique are associated with improvements of diagnostic procedures and protocols, use of new contrast agents and diagnostic algorithms developed with consideration of the otological problem of patients.