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The authors retrospectively enrolled 49 patients, 24 affected by unilateral sudden hearing loss and 25 affected by definite Meniére disease, who had undergone a 4-hour delayed 3D-FLAIR sequence. Two readers analyzed the MR images investigating whether the vestibular endolymphatic space bulged in the third inferior portion of the vestibule contacting the stapes footplate. The vestibular endolymphatic space contacting the oval window has high specificity and positive predictive value in differentiating Meniére disease ears from other ears, thus resulting in a valid tool for ruling in Meniére disease in patients with mimicking symptoms.