Retrospective cohort study reveals electrocochleography outperforms MRI in identifying probable Meniere disease, indicating complementary roles for functional and structural testing.
Key Points
To compare the diagnostic performance and clinical utility of electrocochleography and gadolinium-enhanced inner ear MRI in patients with definite versus probable Menière disease.
Conducted a retrospective cohort study at a tertiary referral center involving 694 patients with Menière disease (765 affected ears: 704 definite and 61 probable), 574 asymptomatic contralateral ears, and 100 healthy control ears.
Evaluated the diagnostic accuracy of extratympanic electrocochleography parameters (amplitude ratio, area1 ratio, area2 ratio) and gadolinium-enhanced inner ear MRI using receiver operating characteristic analysis.
Gadolinium-enhanced MRI demonstrated the highest diagnostic accuracy for differentiating definite Menière disease from non-disease contralateral ears, yielding a sensitivity of 79% and a specificity of 99%.
Electrocochleography parameters, particularly the area2 ratio, outperformed MRI in identifying probable Menière disease compared to non-disease ears, achieving significantly higher area under the curve values (P < 0.05).
Area ratios showed no significant difference between definite and probable disease groups, and findings revealed only weak correlations between MRI structural changes and electrocochleography functional metrics.