Pendred syndrome, defined as the constellation of goiter, sensori-neural hearing 
loss, and positive perchlorate discharge test, is the most frequent cause of 
congenital deafness. Newly introduced diagnostic approaches to the disease are 
rather expensive and complicated, therefore we evaluated the value of MRI as the 
sole, or adjunctive diagnostic approach, and compared it with the traditional 
ones. Presuming the classic triad as the gold standard, we compared MRI findings 
in six such defined patients with six cases having goiter, hearing loss, and 
normal perchlorate discharge test. Our results indicated that MRI was 83.6% 
sensitive and 66.7% specific in patients fulfilling all three criteria 
(complete), while in the 'partial' group the sensitivity and specificity were 
66.7% and 100% respectively. In conclusion, MRI, although impressive as an 
adjunctive diagnostic tool, may not replace the holistic approach, and the 
latter may be more convenient, cheaper, and still more accurate. However in 
'partial' cases with equivocal findings, and in relatives of the patients, MRI 
may be a valuable diagnostic adjunct.