[A comparative study of two imaging evaluation methods for endolymphatic hydrops in unilateral Meniere's disease]

Objective:To compare the application value of two imaging evaluation methods, the Nakashima method and the Bernaerts method, in endolymphatic hydrops（ELH） in Meniere's disease, and to explore the correlation with clinical characteristics. Methods:Data from 54 patients with unilateral lesions were retrospectively analyzed. According to the Nakashima method and the Bernaerts method, the scores and positivity rates of cochlear endolymphatic hydrops（C-ELH）, vestibular endolymphatic hydrops（V-ELH）, and total endolymphatic hydrops（T-ELH） in the affected ears and contralateral ears were obtained. Inter-observer consistency was compared, and the correlations of ELH with disease duration, pure-tone audiometry（PTA）, and caloric test canal paresis（CP） values were analyzed. Results:①Inter-observer consistency: The weighted Kappa coefficients for C-ELH and V-ELH were 0.753 and 0.619 in the Nakashima method, and 0.837 and 0.774 in the Bernaerts method, respectively（all P<0.001）. ②Comparison of positivity rates between affected and contralateral ears: For C-ELH（Nakashima: 74.1% vs 11.1%; Bernaerts: 85.2% vs 13%）, V-ELH（Nakashima: 74.1% vs 7.4%; Bernaerts: 87.0% vs 22.2%）, and T-ELH（Nakashima: 90.7% vs 14.8%; Bernaerts: 92.6% vs 29.6%）, all differences were statistically significant（P<0.01）. No significant differences were found in the positivity rates of C-ELH, V-ELH, or T-ELH in either affected or contralateral ears between the two methods（P>0.05）. ③ Correlation with disease duration: For C-ELH, no correlation was found in the Nakashima method（P>0.05）, but a significant positive correlation was found in the Bernaerts method（P<0.05）. For V-ELH, a significant positive correlation was found in the Nakashima method（P<0.01）, but no correlation was found in the Bernaerts method（P>0.05）. For T-ELH, significant positive correlations were found in both methods（P<0.05）. ④ Correlation with PTA: For both methods, C-ELH showed a significant positive correlation（P<0.01）, V-ELH showed no correlation（P>0.05）, and T-ELH showed a significant positive correlation（P<0.01）. ⑤Correlation with clinical stage: In both methods, C-ELH showed a significant positive correlation（P<0.05）, V-ELH showed no correlation（P>0.05）, and T-ELH showed a significant positive correlation（P<0.05）. ⑥Correlation with CP values: No significant correlations were found between C-ELH, V-ELH, or T-ELH in affected ears and CP values in either method（P>0.05）. Conclusion:The Nakashima method and the Bernaerts method have comparable overall value in terms of the positive rate of endolymphatic hydrops and its correlation with clinical features, but they differ in assessing the relationship between cochlear hydrops, vestibular hydrops, and disease duration. The Bernaerts method is simpler and more efficient in its operational process. In clinical practice, the choice of evaluation method should take other factors into comprehensive consideration.