Simons Jeffrey P, Mandell David L, Arjmand Ellis M
Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Arch Otolaryngol Head Neck Surg. 2006 Feb;132(2):186-92. doi: 10.1001/archotol.132.2.186.
To compare temporal bone computed tomography (CT) with temporal bone and central nervous system magnetic resonance (MR) imaging in children with unilateral or asymmetric sensorineural hearing loss (SNHL).
Retrospective chart study.
Tertiary-care children's hospital.
A total of 131 children with unilateral or asymmetric SNHL, seen consecutively by a single practitioner over 36 months.
Imaging studies were read by a pediatric neuroradiologist and reviewed by the evaluating otolaryngologist.
Prevalence of clinically significant CT or MR imaging findings.
The prevalence of CT abnormalities was 35% for unilateral SNHL, 52% for asymmetric SNHL, and 41% for all patients together. The prevalence of MR imaging abnormalities was 25% for unilateral SNHL, 50% for asymmetric SNHL, and 30% for all patients together. Among 42 subjects who underwent both studies, there were 4 cases in which abnormalities were seen only on MR images and 9 cases in which abnormalities were seen only on CT scans.
Temporal bone and/or central nervous system abnormalities were detected in 42% of 131 patients. When both CT scans and MR images were obtained (n = 42), results were concordant in 69% of cases, and one imaging modality detected clinically significant abnormalities not identified by the other in 31% of cases. The ideal imaging algorithm for children with unilateral or asymmetric SNHL is controversial. We suggest that all children with unilateral or asymmetric SNHL have a high-resolution temporal bone CT scan and that brain and temporal bone MR imaging be obtained in select cases.
比较颞骨计算机断层扫描（CT）与颞骨及中枢神经系统磁共振成像（MR）在单侧或不对称感音神经性听力损失（SNHL）儿童中的应用。
回顾性图表研究。
三级医疗儿童医院。
共有131例单侧或不对称SNHL儿童，由一名医生在36个月内连续诊治。
影像研究由儿科神经放射科医生解读，并由评估的耳鼻喉科医生复查。
具有临床意义的CT或MR成像结果的发生率。
单侧SNHL的CT异常发生率为35%，不对称SNHL为52%，所有患者合计为41%。MR成像异常发生率单侧SNHL为25%，不对称SNHL为50%，所有患者合计为30%。在42例同时接受两项检查的受试者中，有4例仅在MR图像上发现异常，9例仅在CT扫描上发现异常。
131例患者中有42%检测到颞骨和/或中枢神经系统异常。当同时获得CT扫描和MR图像（n = 42）时，69%的病例结果一致，31%的病例中一种成像方式检测到了另一种未发现的具有临床意义的异常。对于单侧或不对称SNHL儿童的理想成像算法存在争议。我们建议所有单侧或不对称SNHL儿童均进行高分辨率颞骨CT扫描，并在特定病例中进行脑部和颞骨MR成像。
