The impact of studying on the hippocampal volume in medical students and its correlation with the results of the Final Medical Examination: a single-centre, prospective observational cohort study.

Purpose: The hippocampus forms part of the limbic system and is involved in the learning process; it is responsible for transferring information from short-term to long-term memory. The aim of our study was to assess the effect of intensive studying on hippocampal volume and whether this correlates with exam results. Material and methods: The analysis included volunteer final-year medical students who underwent 2 volumetric 3D T1 magnetic resonance imaging scans with an interval of 20 weeks: 19 weeks before and one week after the Final Medi-cal Examination. FreeSurfer software was used to compare the volumes of the whole hippocampus and its subfields between the 2 measurements. We assessed correlations between changes in hippocampal volume and the time students spent studying, between changes in hippocampal volume and the results of the exam, and between time spent studying and exam results. Results: Forty participants (25 women and 15 men; mean age 25 years) were included in the analysis. The right hippocampus presubiculum area increased significantly over the study period (p = 0.029), whereas the volume of the left hippocampus remained unchanged. An increase in the volume of the right hippocampus correlated with longer study time (r = 0.371 in percentage and r = 0.397 in mm3) and better LEK exam results (r = 0.441 in percentage and r = 0.456 in mm3). Conclusions: Our research confirms the role of the hippocampus, particularly the subicular complex, in the process of learning and remembering, and suggest that the plastic abilities of the hippocampus depend on the intensity of learning and translate into better skills.

Detailed insight into magnetic resonance assessment of Ménière's disease - description of methodology and imaging findings in a case series.

Purpose: The study aimed to describe the methodology and detailed interpretation of magnetic resonance imaging (MRI) in patients with Ménière's disease (MD). Material and methods: MRIs were performed on a 3T scanner. The three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence 4 hours after a double dose of intravenous contrast was added to the standard MRI protocol in patients with clinically diagnosed MD. MRI findings of 7 patients with unilateral MD were analysed using 2 qualitative grading systems by Barath and Bernaerts. Results: In MRI, the following changes in the group of patients with MD were observed: lack of endolymphatic hydrops (cases #1 and #7), various grades of cochlear hydrops (cases #2 and #3), various grades of vestibular hydrops (cases #4, #5, and #6), endolymphatic hydrops herniation into the semi-circular canal (case #6), and more robust perilymphatic enhancement (case #7). Conclusions: In patients with MD, endolymphatic hydrops can be studied on MRI using 3D-FLAIR delayed post-contrast images. The qualitative grading system may be easily used in endolymphatic hydrops assessment. Recently described new radiological signs of MD such as increased perilymphatic enhancement of the cochlea and an extra low-grade VH may increase MD diagnosis sensitivity. MRI not only supports the clinical diagnosis of MD but also may help to understand its pathophysiology.

An X-ray lead screen may be used to reduce an interventional radiologist's radiation exposure during CT-guided procedures.

Purpose: The exposure of both patient and operator to radiation is one of the limitations of computed tomography (CT)-guided interventions, and it should be kept as low as reasonably possible. The purpose of the study was to evaluate the efficacy of a lead screen in reducing the radiation dose to an operator in the course of CT-guided interventions. Material and methods: This prospective study analysed data collected from 72 consecutive CT-guided procedures, all of which were performed with an X-ray protective lead screen placed between the scanner and the operator. Five dosimeters were placed in the CT scanning room, and accumulated radiation doses were measured for each dosimeter. Results: The dosimeter placed on the gantry side of the lead screen revealed highest levels of radiation (11.33 ± 1.93 mSv), which were significantly higher than those at all other dosimeters. The radiation dose behind the lead screen was almost the same when measured by dosimeters on the CT scanner gantry side and 3 metres away from it. The presence of the screen caused no discomfort for operators. Conclusions: A lead screen reduces an operator's radiation exposure significantly, while not posing any obstacles or causing any discomfort while CT-guided procedures are carried out.

Validation of exophthalmos magnetic resonance imaging measurements in patients with Graves' orbitopathy, compared to ophthalmometry results.

Purpose: Although assessment of the orbital structures using magnetic resonance imaging (MRI) is well described in the literature, there is no consensus as to which measurement method is the most useful in exophthalmos assessment. The aim of the study was to correlate 2 MRI methods of exophthalmos measurement with exophthalmometry results and to determine a proper technique of exophthalmos measurement. Material and methods: Fifty-four patients (108 orbits) with exophthalmos in the course of Graves' orbitopathy were enrolled in the study. Two measurements on axial T2W orbital MRI images were performed by 2 independent radiologists: the distance from the interzygomatic line to the anterior surface of the globe (AD) and the distance from the interzygomatic line to the posterior sclera (PD). Within 4 weeks, an exophthalmometry was performed by an ophthalmologist using a Hertel exophthalmometer. The inter-observer variation was assessed using the Pearson correlation coefficient. Values were presented as mean and standard deviation, and the differences in values were explored with Student's t-test. Results: The mean AD measured on MRI by the first observer was 20.6 ± 3 mm, and 20.6 ± 2.9 mm by the second observer. PD values were 2.9 ± 2.8 mm and 3.4 ± 2.8 mm, respectively. The mean exophthalmometry result was 21 ± 3.3 mm. The correlation was very high between observers for AD measurements (r = 0.98, p = 0.01) and high for PD measurements (r = 0.95, p = 0.01). AD measurements on MRI and exophthalmometry results were strongly correlated (r = 0.9, p = 0.01). Conclusions: The AD measurement has better reproducibility and is directly correlated with Hertel exophthalmometry. This method could be sufficient in routine practice.

Age- and gender-dependent variability in the geometry of middle cerebral artery bifurcations.

The goal of this study was to analyze trends in the geometric parameters of blood vessels with age in a randomly selected group of 200 computed tomography angiography studies of radiologically healthy individuals using dedicated statistical techniques. A quantitative description of cerebral vascular geometry with numerical parameters (bifurcation angle, branching angle, co-planarity index, average curvature, and average torsion) was proposed. The changes and variability in geometry were analyzed according to age. The bifurcation angle, branching angle, and average curvature increased with age, whereas the co-planarity index and average torsion decreased with age. For equal-diameter branches, women comparing to men presented lower bifurcation angles in the 4th decade of life, and lower values for the co-planarity index in the 3rd and 4th decades of life. In non-equal-diameter branches, the opposite relationship was observed for bifurcation angle in the 4th decade of life comparing both groups. All analyzed parameters showed clearly visible trends with patient age. Deviations in specific decades of life were detected; these deviations could be linked to the development of aneurysms in specific age groups.

Ultra-low radiation dose protocol for CT-guided intrathecal nusinersen injections for patients with spinal muscular atrophy and severe scoliosis.

PURPOSE: Intrathecal injection of nusinersen is an approved treatment of spinal muscular atrophy (SMA). CT-guided injection is a method of nusinersen administration in patients with severe scoliosis, in whom standard lumbar puncture is not feasible. The injections are repeated every 4 months for life, and accumulated radiation doses absorbed by the patient can increase the risk of cancer. In this study, we present the results of CT-guided intrathecal nusinersen injections with an ultra-low radiation dose protocol. METHODS: Eighteen patients (15 adults and three children) in whom standard lumbar puncture was not feasible due to severe scoliosis or spinal stabilization were included in this retrospective study. The first 23 injections were performed with a standard radiation dose protocol and the next 42 injections with an ultra-low-dose protocol. The radiation doses, measured as total dose length product (DLP), were acquired and compared between the protocols. RESULTS: Injections were successful in 100% of patients with both ultra-low-dose and standard protocols. The radiation dose, measured as DLP, was 111.2-1100.7 (Me = 248.1) mGy*cm for the standard protocol. For the ultra-low-dose protocol, the dose range was 5.0-54.4 (Me = 26.7) mGy*cm, which was significantly lower than with the standard protocol (p < 0.001, η2 = 0.67). CONCLUSION: Radiation doses can be significantly decreased in the CT-guided injection of nusinersen. The proposed protocol allows for effective CT-guided intrathecal nusinersen administration in patients with SMA and severe scoliosis.

Selective occlusion of splenic artery aneurysms with the coil packing technique: the impact of packing density on aneurysm reperfusion correlated between contrast-enhanced MR angiography and digital subtraction angiography.

PURPOSE: The aim was to evaluate the relationship between coil packing densities after splenic artery aneurysm (SAA) treatment using detachable microcoils and rates of SAA reperfusion and to suggest a post-treatment surveillance protocol using contrast-enhanced MRA. MATERIALS AND METHODS: Evaluated were 16 patients (4 men; mean age 46.7), who underwent true SAA embolization using detachable microcoils (Concerto, Medtronic). SAAs were treated by selective coil packing (CP) or stent-assisted coil exclusion (SAC). Contrast-enhanced magnetic resonance angiography (CE-MRA) and digital subtraction angiography (DSA) were performed at 3 months post-procedure and correlated. RESULTS: Primary CP was used in 13 patients, while SAC was used in three patients. On follow-up, complete aneurysm occlusion was seen in seven patients (43.8%). Sac reperfusion occurred in nine patients (56.2%) and was demonstrated in all CE-MRA and six DSA studies. Mean aneurysm packing density was 20.10 ± 8.05% for the CP group and 32.90 ± 11.95% for the SAC group (p = 0.038). There was a significant difference in the incidence of aneurysm sac reperfusion on CE-MRA study between CP and SAC (9 vs. 0). No sac reperfusion was seen in aneurysms with packing densities ≥ 29%, irrespective of either embolization method. CONCLUSION: Favorable midterm results for coil packing of SAAs seem to depend on the coil packing density with a coil volume approximately a quarter of the aneurysm volume being most effective. Follow-up should involve the use of CE-MRA as this modality has been shown to be superior over DSA in detecting aneurysm reperfusion and coil compaction. LEVEL OF EVIDENCE: Level IV, therapeutic study.

Computed tomography evaluation of patent paraumbilical vein and its aneurysm in relation to other portosystemic collateral channels in patients with liver cirrhosis and portal hypertension.

PURPOSE: The aim of the study was to evaluate the relationship between the diameter and aneurysmal dilatation of the paraumbilical vein (PUV) and the presence of portosystemic collateral shunts and their relationship with age and portal vein diameter. MATERIAL AND METHODS: The retrospective analysis, performed in the II Department of Radiology, Medical University Hospital in Warsaw, included 126 patients (77 males and 49 females) with patent umbilical vein and signs of portal hypertension due to liver cirrhosis. All patients underwent contrast enhanced abdominal CT. The average age was 54.7 ±12.98. We analysed the number and type of portosystemic collateral channels in respect of age, sex, presence of oesophageal varices, and the diameter of the paraumbilical vein and the portal vein. RESULTS: Our results disclosed statistically significant negative correlation between patient age and diameter of paraumbilical vein, number of portosystemic collateral channels and diameter of portal vein and positive correlation between diameter of paraumbilical vein and diameter of portal vein. A statistically significant difference in diameter of portal vein and number of collateral channels was found in groups with and without oesophageal varices. No significant difference in age and portal vein diameter was found in these groups. CONCLUSIONS: Our study showed that younger patients with liver cirrhosis are characterised by wider paraumbilical veins and higher number of portosystemic collateral channels. The presence of oesophageal varices does not correlate with age, sex, diameter of paraumbilical vein, and number of collateral portosystemic channels.

Promoting False-Lumen Thrombosis after Thoracic Endovascular Aneurysm Repair in Type B Aortic Dissection by Selectively Excluding False-Lumen Distal Entry Tears.

PURPOSE: To evaluate the efficacy and clinical outcomes of ancillary endovascular procedures in promoting false-lumen (FL) thrombosis (FLT) and preventing aortic expansion in patients after thoracic endografting for type B dissections. MATERIALS AND METHODS: This retrospective review included 15 patients (12 men and 3 women; mean age, 59.6 y). Mean aortic diameter at the time of ancillary treatment was 47.4 mm. Different techniques were used as single procedures or sequentially: covered stent occlusion of detached visceral artery entry tears, occlusion of single entry tears with vascular plugs, or aortic endograft occlusion of multiple FL entry tears. FL embolization with ethylene vinyl alcohol copolymer was performed when selective occlusion was considered insufficient to close distal entry tears. Apart from endovascular aneurysm repair, all procedures were performed percutaneously under local anesthesia. If FL diameter increase persisted after 6-month follow-up computed tomographic (CT) angiography, another intervention was planned; otherwise, yearly follow-up was performed. RESULTS: Mean clinical follow-up duration was 43.8 months (range, 8 d to 86.8 mo), with no in-hospital mortality. Estimated overall survival rates were 93.3%, 86.6%, and 77% at 12, 24, and 48 months, respectively. Three late deaths occurred, one of which was dissection-related at 40 months. Eight surviving patients (53%) had total FLT and 3 had partial FLT with stable aortic diameter on follow-up CT angiography. FL diameter increased in one patient, requiring further intervention. CONCLUSIONS: Selective exclusion of new distal entry tears remaining after thoracic endovascular aneurysm repair can stabilize abdominal aortic expansion and promote FLT.

Correlation Between Findings of Multislice Helical Computed Tomography (CT), Endoscopic Examinations, Endovascular Procedures, and Surgery in Patients with Symptoms of Acute Gastrointestinal Bleeding.

BACKGROUND: Endoscopic methods (gastroscopy and colonoscopy) are considered fundamental for the diagnosis of gastrointestinal bleeding. In recent years, multidetector computed tomography (MDCT) has also gained importance in diagnosing gastrointestinal bleeding, particularly in hemodynamically unstable patients and in cases with suspected lower gastrointestinal tract bleeding. CT can detect both the source and the cause of active gastrointestinal bleeding, thereby expediting treatment initiation. MATERIAL/METHODS: The study group consisted of 16 patients with clinical symptoms of gastrointestinal bleeding in whom features of active bleeding were observed on CT. In all patients, bleeding was verified by means of other methods such as endoscopic examinations, endovascular procedures, or surgery. RESULTS: The bleeding source was identified on CT in all 16 patients. In 14 cases (87.5%), bleeding was confirmed by other methods. CONCLUSIONS: CT is an efficient, fast, and readily available tool for detecting the location of acute gastrointestinal bleeding.

Gd-EOB-DTPA-Enhanced MR Imaging of the Liver: The Effect on T2 Relaxation Times and Apparent Diffusion Coefficient (ADC).

BACKGROUND: To investigate the effect of gadoxetic acid disodium (Gd-EOB-DTPA) on T2 relaxation times and apparent diffusion coefficient (ADC) values of the liver and focal liver lesions on a 1.5-T system. MATERIAL/METHODS: Magnetic resonance (MR) studies of 50 patients with 35 liver lesions were retrospectively analyzed. All examinations were performed at 1.5T and included T2-weighted turbo spin-echo (TSE) and diffusion-weighted (DW) images acquired before and after intravenous administration of Gd-EOB-DTPA. To assess the effect of this hepatobiliary contrast agent on T2-weighted TSE images and DW images T2 relaxation times and ADC values of the liver and FLLs were calculated and compared pre- and post-injection. RESULTS: The mean T2 relaxation times of the liver and focal hepatic lesions were lower on enhanced than on unenhanced T2-weighted TSE images (decrease of 2.7% and 3.6% respectively), although these differences were not statistically significant. The mean ADC values of the liver showed statistically significant decrease (of 4.6%) on contrast-enhanced DW images, compared to unenhanced images (P>0.05). The mean ADC value of liver lesions was lower on enhanced than on unenhanced DW images, but this difference (of 2.9%) did not reach statistical significance. CONCLUSIONS: The mean T2 relaxation times of the liver and focal liver lesions as well as the mean ADC values of liver lesions were not significantly different before and after administration of Gd-EOB-DTPA. Therefore, acquisition of T2-weighted and DW images between the dynamic contrast-enhanced examination and hepatobiliary phase is feasible and time-saving.

CT Angiography in the Diagnosis of Brain Death.

Summary Brain death is defined as the irreversible cessation of functioning of the entire brain, including the brainstem. Brain death is principally established using clinical criteria including coma, absence of brainstem reflexes and loss of central drive to breathe assessed with apnea test. In situations in which clinical testing cannot be performed or when uncertainty exists about the reliability of its parts due to confounding conditions ancillary tests (i.a. imaging studies) may be useful. The objective of ancillary tests in the diagnosis of brain death is to demonstrate the absence of cerebral electrical activity (EEG and evoked potentials) or cerebral circulatory arrest. In clinical practice catheter cerebral angiography, perfusion scintigraphy, transcranial Doppler sonography, CT angiography and MR angiography are used. Other methods, like perfusion CT, xenon CT, MR spectroscopy, diffusion weighted MRI and functional MRI are being studied as potentially useful in the diagnosis of brain death. CT angiography has recently attracted attention as a promising alternative to catheter angiography - a reference test in the diagnosis of brain death. Since 1998 several major studies were published and national guidelines were introduced in several countries (e.g. in France, Austria, Switzerland, the Netherlands and Canada). This paper reviews technique, characteristic findings and criteria for the diagnosis of cerebral circulatory arrest in CT angiography.

Characterization of focal liver lesions using quantitative techniques: comparison of apparent diffusion coefficient values and T2 relaxation times.

OBJECTIVES: To compare the efficacy of two quantitative methods for discrimination between benign and malignant focal liver lesions (FLLs): apparent diffusion coefficient (ADC) values and T2 relaxation times. METHODS: Seventy-three patients with 215 confirmed FLLs (115 benign, 100 malignant) underwent 1.5-T MRI with respiratory-triggered single-shot SE DWI (b = 50, 400, 800) and dual-echo T2TSE (TR = 3,000 ms; TE1 = 84 ms; TE2 = 228 ms). ADC values and T2 relaxation times of FLLs were calculated. Sensitivity, specificity and accuracy of both techniques in diagnosing malignancy were assessed. RESULTS: The mean ADC value of malignant tumours (1.07 × 10(-3) mm(2)/s) was significantly lower (P < 0.05) than that of benign lesions (1.86 × 10(-3) mm(2)/s ); however, with the use of the optimal cut-off value of 1.25 × 10(-3) mm(2)/s, 20 false positive (FP) and 20 false negative (FN) diagnoses of malignancy were noted, generating 79 % sensitivity, 82.6 % specificity and 80.9 % accuracy. The mean T2 relaxation time of malignant tumours (64.4 ms) was significantly lower (P < 0.05) than that of benign lesions (476.1 ms). At the threshold of 107 ms 22 FP and 1 FN diagnoses were noted; the sensitivity was 99 %, specificity 80.9 % and accuracy 89.3 %. CONCLUSIONS: Quantitative analysis of T2 relaxation times yielded significantly higher sensitivity and accuracy in diagnosing malignant liver tumour than ADC values. KEY POINTS: • Diffusion-weighted magnetic resonance imaging is increasingly used for liver lesions. • But ADC values demonstrated only moderate accuracy for differentiation of liver lesions. • T2 relaxation times yielded higher accuracy in diagnosing malignant liver tumours. • Both ADC and T2 values overlapped between focal nodular hyperplasia and malignant lesions. • Nevertheless T2 liver mapping could be valuable for evaluating focal liver lesions.

[Ultrasound-guided aspiration for treatment of symptomatic cystic adventitial disease of the popliteal artery]. / Opis przypadku przezskórnej aspiracji torbieli podprzydankowej tetnicy podkolanowej wykonanej pod kontrola USG.

Cystic adventital disease is a very rare lesion of peripheral arteries. The cysts usually occur in the popliteal arteries, they contain gelatinous substance and by eccentric compression of the lumen of the artery may cause calf claudication. We report a case of decompression of the popliteal artery by percutaneous ultrasound guided adventitial cyst aspiration in an 80-year-old patient complaining of intermittent claudication. The procedure resulted in normal flow in the popliteal artery and resolution of symptoms. Such procedure is efficacious, safe and can be performed on an outpatient basis.

[Percutaneous angioplasty for early hepatic artery thrombosis after orthotopic liver transplantation--case report]. / Przezskórna angioplastyka we wczesnej zakrzepicy tetnicy watrobowej watroby przeszczepionej--opis przypadku.

Hepatic artery thrombosis is the most frequent arterial complication after orthotopic liver transplantation. In the past, surgical treatment was required to remove the thrombus, otherwise another liver transplantation was needed. Recently, interventional treatment has become an important method in treating hepatic artery occlusion. We present our experience of the case of percutaneous angioplasty in patient with hepatic artery thrombosis after orthotopic liver transplantation. Percutaneous angioplasty with a 5 mm balloon was done immediately after diagnosis and blood flow was obtained. A stent was not placed. We observed good hepatic artery patency and graft function during the followup period of 8 months. Percutaneous angioplasty may be considered the first-line therapy for early hepatic artery thrombosis after OLT.

[Embolotherapy of recanalized symptomatic pulmonary arteriovenous malformations in a patient with Rendu-Osler-Weber syndrome: a case report and review of literature]. / Powtórna embolizacja objawowych przetok tetniczo-zylnych pluc u pacjentki z choroba Rendu-Oslera-Webera: opis przypadku i przeglad pismiennictwa.

Rendu-Osler-Weber disease is a genetic disorder resulting in mucosal and celiac angiodysplastic lesions. We present a case of a 47-year-old woman with Rendu-Osler-Weber disease manifesting with telangiectasias on the skin and mucosa of the face and pulmonary and hepatic arteriovenous malformations (AVMs). Due to cardiovascular and neurological (recurrent brain abscess) complications of pulmonary AVMs, the patient was qualified for the embolization of a recanalized AVM in the right lung. Endovascular embolotherapy is the method of choice in treatment of pulmonary AVMs allowing for avoidance of complications and prolonged survival. Due to the risk of recanalization of embolized AVMs, a long-term follow up is necessary.

MRI-guided fiducial marker implantation as a method of tagging an ultrasound- and non-enhanced CT-invisible liver tumor before thermal ablation.

Some liver tumors are not visible on ultrasound or non-enhanced CT (NECT) which are main modalities used in image-guided ablations. This is a report of MR-guided implantation of fiducial marker to tag a neuroendocrine tumor metastasis in a patient with renal insufficiency precluding the use of contrast - enhanced CT during ablation. The marker was well visible on NECT which allowed for precise needle placement and complete ablation which was confirmed in 12-months follow-up.

Inter-observer agreement using the LI-RADS version 2018 CT treatment response algorithm in patients with hepatocellular carcinoma treated with conventional transarterial chemoembolization.

AIM: To determine inter-reader agreement in categorization of imaging features using the Liver Imaging Reporting and Data System (LI-RADS) treatment response (LR-TR) algorithm in patients with hepatocellular carcinoma (HCC) treated with conventional transarterial chemoembolization (cTACE). METHODS: Two radiologists used the LR-TR algorithm to assess 112 computed tomography (CT) examinations of 102 patients treated with cTACE. The inter-observer agreement in categorization of LR-TR features was assessed using kappa (κ) statistics. RESULTS: There was substantial inter-observer agreement between the two reviewers using the LR-TR algorithm (κ = 0.70; 95% CI 0.58-0.81). The two reviewers categorized tumors as non-viable in 37 (33.0%) and 39 (34.8%) of 112 examinations, viable in 58 (51.8%) and 62 (55.4%) examinations, and equivocal in 18 (16.1%) and 11 (9.8%) examinations, respectively. There was almost perfect inter-observer agreement for the LR-TR non-viable category (κ = 0.80; 95% CI 0.68-0.92), substantial agreement for the viable category (κ = 0.78 95% CI 0.67-0.90), and fair agreement for the equivocal category (κ = 0.25; 95% CI 0.02-0.49). CONCLUSION: The LR-TR algorithm conveys high degrees of inter-observer agreement for the assessment of CT imaging features in the viable and non-viable categories. Further refinement of indeterminate features may be necessary to improve the correct categorization of equivocal lesions.

Correlation between magnetic resonance imaging classification of endolymphatic hydrops and clinical manifestations and audiovestibular test results in patients with definite Ménière's disease.

OBJECTIVES: The purpose was to evaluate magnetic resonance imaging (MRI) classification of endolymphatic hydrops with clinical features, audiological and vestibular tests in patients with definite unilateral Ménière's disease (MD). METHODS: Thirty-eight patients were enrolled in this study. The severity of the main clinical symptoms, audiovestibular tests, and MRI, performed 4 hours after intravenous injection of gadobutrol to visualize inner ear compartments, were evaluated. Endolymphatic space dilatation was assessed using Barath and Bernaerts grading systems, and the correlation between the grade of the hydrops and clinical features was evaluated. RESULTS: Using the Barath system, cochlear hydrops was visualized in 81.6% of affected ears, while vestibular was 63.2%. Sensitivity increased to 94.7% using Bernaerts' modification. Vestibular hydrops involving the utricle was present only among patients with cochlear and saccular endolymphatic space dilatation. There was a significant relationship between the hearing level and the vestibular hydrops degree in the Bernaerts scale. The grade of the hydrops correlated neither with the duration of MD nor with the severity of main clinical symptoms. Our study proved MRI to be a sensitive diagnostic tool in MD. The endolymphatic hydrops' grade correlates with the hearing level, which confirms endolymphatic space dilatation's role in hearing loss. CONCLUSIONS: In our study, two similar MRI grading systems were used; however, several differences were found compared to one another. The Bernaerts scale was more sensitive than the Barath scale, and several relationships between the radiological and clinical data were found. Therefore, several MRI evaluating scales and correlating them with the clinical features are needed. The increased perilymphatic enhancement of the cochlea and an extra low-grade vestibular hydrops distinguished in the Bernaerts scale may increase MD diagnosis sensitivity. Magnetic resonance findings in MD support the clinical diagnosis and may help to understand MD pathophysiology better. This study adds to the knowledge and diagnostics in MD for healthcare to improve patients' treatment.