Endolymphatic hydrops (EH) is defined as the enlargement of the endolymphatic spaces within the inner ear. Its diagnostic used to be only feasible on post mortem studies and it was from the very beginnig highly associated with Ménière's Disaese (MD). Visibility on imaging was initially possible using 3T MRI scanners but with the advancement of imaging techniques and with new more powerful MRI scanners, it is now also feasible on 1.5T.

Endolymphatic hydrops is usually a primary disease, with no underlying cause; this condition is known as Ménière's Disease. In some instances, it can be secondary to a myriad of pathologic processes that affect the middle and/or the inner ear such as: labyrinthitis, trauma, noise induced hearing loss and tumors such as vestibular shwannomas. In these cases, imaging plays a key part in differenciating secondary from primary endolymphatic hydrops which can have important consequences on both prognosis and treatment plans.

We collected all the MRI performed in our department which included the late-enhanced 3D-FLAIR sequence during a period that spanned from March 2022 to March 2024. All imaging was performed on a 1.5 T MRI system, SIGNA Artist (GE). We used a 3D FSE (CUBE) FLAIR sequence performed 4 hours after the administration of Gadolinium.

We looked for the cases in which an etiology for endolymphatic hydrops was found either on imaging or from clinical findings. In the following, we describe the clinical and radiological findings of these patients.