Deep Nicholas L, Carlson Matthew L, Weindling Steven M, Barrs David M, Driscoll Colin L W, Lohse Christine M, Lane John I, Hoxworth Joseph M
*Department of Otorhinolaryngology, Mayo Clinic, Phoenix, Arizona †Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota ‡Neuroradiology Division, Department of Radiology, Mayo Clinic, Jacksonville, Florida §Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota ||Neuroradiology Division, Department of Radiology, Mayo Clinic, Rochester, Minnesota ¶Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona.
Otol Neurotol. 2017 Aug;38(7):948-955. doi: 10.1097/MAO.0000000000001482.
To compare the diagnostic yield of high-resolution volumetric T2-weighted MRI (HRT2-MRI) with high-resolution computed tomography (HRCT) for diagnosis of large vestibular aqueduct (LVA).
Three board-certified neuroradiologists performed an independent, blinded radiological review for diagnosing LVA with 2:1 age-matched controls on patients with both HRCT and HRT2-MRI imaging.
Tertiary referral center.
All patients between 2002 and 2016 with hearing loss who underwent both HRCT and HRT2-MRI and were diagnosed with LVA on either modality.
Concordance rate for LVA between HRCT and HRT2-MRI.
Concordance rate for HRCT and HRT2-MRI for diagnosing LVA was 88% (124/141) when assessing both the midpoint and external aperture diameters. Fifteen ears had LVA on computed tomography (CT), but not on magnetic resonance imaging (MRI); in comparison, two ears had LVA on MRI, but not on CT (p = 0.002). Excellent inter-rater reliability among the three radiologists was demonstrated.
Historically, HRCT has been the imaging modality of choice for diagnosing LVA. Although a higher concordance rate of HRT2-MRI was found compared with previous studies utilizing earlier MRI technology, HRCT still detected a larger number of patients with clinically significant hearing loss compared with MRI. Given the high concordance rate and efficacy of both modalities in diagnosing LVA, the ultimate decision of which modality to choose may depend on other patient-specific and clinical factors.
比较高分辨率容积T2加权磁共振成像（HRT2-MRI）与高分辨率计算机断层扫描（HRCT）对大前庭导水管（LVA）的诊断效能。
三位具有专业委员会认证的神经放射科医生对同时进行了HRCT和HRT2-MRI检查的患者进行独立、盲法的影像学评估，以诊断LVA，并与年龄匹配的对照患者按2:1比例进行比较。
三级转诊中心。
2002年至2016年间所有因听力损失同时接受了HRCT和HRT2-MRI检查且在其中任何一种检查方式下被诊断为LVA的患者。
HRCT与HRT2-MRI对LVA的诊断符合率。
在评估中点和外口直径时，HRCT和HRT2-MRI诊断LVA的符合率为88%（124/141）。15只耳朵在计算机断层扫描（CT）上显示有LVA，但在磁共振成像（MRI）上未显示；相比之下，2只耳朵在MRI上显示有LVA，但在CT上未显示（p = 0.002）。三位放射科医生之间显示出极好的评分者间信度。
从历史上看，HRCT一直是诊断LVA的首选成像方式。尽管与之前使用早期MRI技术的研究相比，HRT2-MRI的符合率更高，但与MRI相比，HRCT仍能检测出更多有临床显著听力损失的患者。鉴于两种方式在诊断LVA方面的高符合率和有效性，最终选择哪种方式可能取决于其他患者特异性和临床因素。
