Objective: To explore the positive visualization rate of endolymph space in Meniere's disease (MD) by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) and assess its diagnostic value of MD.

Methods: 3D-FLAIR MRI was performed at 24 h after an intratympanic injection of gadolinium diethylenetriamine penta-acetic acid in 51 MD patients. Then the examination results were summarized, analyzed and compared with those of vestibular evoked myogenic potential (VEMP) and glycerol tests.

Results: Gadolinium was found in perilymph inside inner ear. Furthermore the border between perilymph and endolymph was visible so that endolymphatic space was distinctly visualized on 3D-FLAIR MRI. Forty-nine (96.1%) patients demonstrated the signs of endolymphatic hydrops. Statistically significant differences existed between the results of 3D-FLAIR MRI and those of VEMP and glycerol tests (P < 0.05). No complication of tympanic membrane perforation or infection was observed.

Conclusion: After an intratympanic injection of gadolinium, 3D-FLAIR MRI has a higher positive rate in MD patients. Though as an invasive procedure, it has fewer side effects and will become an important diagnostic tool for MD.

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