From the Edward B. Singleton Department of Radiology (G.O., M.K.K., N.D., T.A.G.M.H., S.F.K.)
From the Edward B. Singleton Department of Radiology (G.O., M.K.K., N.D., T.A.G.M.H., S.F.K.).
AJNR Am J Neuroradiol. 2020 Jun;41(6):1081-1086. doi: 10.3174/ajnr.A6539. Epub 2020 May 21.
Bacterial meningitis most commonly affects young children and can result in critical adverse outcomes, including sensorineural hearing loss (SNHL). The purpose of this study is to determine the diagnostic accuracy of MR imaging for predicting the development of SNHL among infants with bacterial meningitis.
A retrospective review was performed among infants (age <365 days) with bacterial meningitis ( = 115). Independent and consensus blinded review of brain MRIs ( = 239) performed less than 90 days from presentation were conducted. Abnormal appearance of the inner ear was defined as enhancement on postcontrast T1-weighted (T1-weighted+C) sequence and FLAIR hyperintensity. The consensus MR imaging appearance of the inner ear on FLAIR, T1-weighted+C, and combined evaluation was compared with criterion standard audiometric testing to determine the sensitivity and specificity of MR imaging for detecting SNHL.
The mean age at diagnosis of bacterial meningitis was 50.6 days (range, 0-338 days) and 24.3% had SNHL. Sensitivity and specificity was 0.61/0.96, 0.50/0.94, and 0.61/0.94 for T1-weighted+C, FLAIR hyperintensity, and combined evaluation, respectively, for prediction of SNHL. There was excellent interobserver agreement for both the T1-weighted+C and FLAIR sequences and combined evaluation for presence of abnormal enhancement and hyperintense signal, respectively. Factors associated with abnormal MR imaging findings on T1-weighted+C and/or FLAIR in patients with SNHL included low CSF glucose (= .04, .02) and high CSF protein (= .04, .03).
Abnormal enhancement and/or FLAIR hyperintensity of the inner ear demonstrate high specificity and average sensitivity for prediction of SNHL among infants with bacterial meningitis.
细菌性脑膜炎最常影响幼儿，并可能导致严重的不良后果，包括感音神经性听力损失（SNHL）。本研究旨在确定 MRI 对预测细菌性脑膜炎婴儿 SNHL 发展的诊断准确性。
对（年龄 <365 天）患有细菌性脑膜炎的婴儿（n=115）进行了回顾性研究。对就诊后 <90 天进行的脑 MRI（n=239）进行了独立和共识盲法评估。增强后 T1 加权（T1-weighted+C）序列和 FLAIR 高信号的内耳异常表现定义为增强。内耳在 FLAIR、T1-weighted+C 和联合评估中的共识 MRI 表现与标准听力测试进行比较，以确定 MRI 检测 SNHL 的敏感性和特异性。
细菌性脑膜炎的平均诊断年龄为 50.6 天（范围 0-338 天），24.3%的患儿出现 SNHL。T1-weighted+C、FLAIR 高信号和联合评估对 SNHL 的预测敏感性和特异性分别为 0.61/0.96、0.50/0.94 和 0.61/0.94。T1-weighted+C 和 FLAIR 序列以及联合评估对异常增强和高信号的存在具有极好的观察者间一致性。SNHL 患儿 T1-weighted+C 和/或 FLAIR 异常 MRI 发现的相关因素包括脑脊液葡萄糖低（=.04，.02）和脑脊液蛋白高（=.04，.03）。
内耳异常增强和/或 FLAIR 高信号对预测细菌性脑膜炎婴儿 SNHL 具有高特异性和平均敏感性。
