The diagnostic performance of cochlear endolymphatic hydrops and perilymphatic enhancement in stratifying Ménière’s disease probabilities: A meta-analysis of semi-quantitative MRI-based grading systems

Neda Azarpey, Shahrzad-Sadat Seyed-Bagher-Nazeri, Omid Yazdani, Romina Esbati, Paria Boustani, Mobasher Hajiabbasi, Pouya Torabi, Dorreh Farazandeh, Hana Farzaneh, Ashkan Azizi, Behnam Amini, Moein Ghasemi and Zohre Ghasemi

PLOS ONE, 2024, vol. 19, issue 11, 1-19

Abstract: Background: The diagnosis of Meniere’s Disease (MD) presents significant challenges due to its complex symptomatology and the absence of definitive biomarkers. Advancements in MRI technology have spotlighted endolymphatic hydrops (EH) as a key pathological marker, necessitating a reevaluation of its diagnostic utility amidst the need for standardized and validated MRI-based grading scales. Methods: Our meta-analysis scrutinized the diagnostic efficacy of semi-quantitative MRI-based cochlear endolymphatic hydrops (EH) and perilymphatic enhancement (PLE) grading systems in delineating clinically relevant discriminations: “Spotting” the shift from normal or asymptomatic ears to possible/probable MD (pMD), “Confirming” the progression to definite MD (dMD), and “Establishing” the presence of dMD. A thorough literature search up to October 2023 resulted in 35 pertinent studies, forming the basis of our analysis through a bivariate mixed-effects regression model. Results: Using criteria from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and Barany Society, across varying thresholds and disease probabilities; the Establishment model at an EH grade 1 threshold revealed a sensitivity of 85.4% and a specificity of 82.7%. Adjusting the threshold to EH grade 2 results in a sensitivity increase to 92.1% (CI: 85.9–95.7) and a specificity decrease to 70.6% (CI: 64.5–76.1), with a DOR of 28.056 (CI: 14.917–52.770). The Confirmation model yields a DOR of 5.216, indicating a lower diagnostic accuracy. The Spotting model demonstrates a sensitivity of 48.3% (CI: 34.8–62.1) and a specificity of 88.0% (CI: 77.8–93.9), with a DOR of 6.882. The normal ears subgroup demonstrated a notably high specificity of 89.7%, while employing Nakashima’s criteria resulted in a reduced sensitivity of 74.9%, significantly diverging from other systems (p-value

Date: 2024
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0310045 (text/html)
https://journals.plos.org/plosone/article/file?id= ... 10045&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0310045

DOI: 10.1371/journal.pone.0310045

Access Statistics for this article

More articles in PLOS ONE from Public Library of Science
Bibliographic data for series maintained by plosone ().