MRI对听力损失儿童扩大前庭导水管评估的诊断效能
The Diagnostic Efficacy of MRI in the Evaluation of the Enlarged Vestibular Aqueduct in Children with Hearing Loss.
作者信息
Sarıoğlu Fatma Ceren, Çetin Aslı Çakır, Güleryüz Handan, Güneri Enis Alpin
机构信息
Division of Pediatric Radiology, Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Department of Otorhinolaryngology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
出版信息
Turk Arch Otorhinolaryngol. 2020 Dec;58(4):220-226. doi: 10.5152/tao.2020.5864. Epub 2020 Oct 28.
OBJECTIVE
The aim of our study is to evaluate the diagnostic effectiveness of magnetic resonance imaging (MRI) compared to computed tomography (CT) in the detection of enlarged vestibular aqueduct (EVA) in childhood.
METHODS
One hundred twenty-three children who underwent temporal bone CT and MRI examinations for hearing loss between 2013 and 2020 were evaluated retrospectively. All CT and MRI images were examined by two pediatric radiologists, according to the Valvassori and Cincinnati criteria for EVA. Imaging findings on CT and MRI of the vestibular aqueduct were recorded. Two pediatric radiologists performed the measurements for EVA on CT and MRI. In addition, an otolaryngologist performed the measurements independently. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI compared to CT were calculated to detect EVA. The difference between the measurements on CT and MRI was investigated. The inter-observer agreement was evaluated for measurements.
RESULTS
The mean age of 123 children (65 boys and 58 girls) was 50.18±50.40 months. Two hundred forty-six ears were evaluated in 123 children. On CT images, EVA was present in 28 (11.3%) of 246 ears according to Cincinnati criteria and 27 (10.9%) of 246 ears according to Valvassori criteria, respectively. While sensitivity, specificity, PPD, and NPD rates of MRI were 100%, 99%, 92.8%, and 100%, respectively, for Cincinnati criteria, for Valvassori criteria, they were 100%, 97.3%, 77.7%, and 100%, respectively. According to the visual evaluation performed without using measurement, the enlarged appearance of the vestibular aqueduct was significant for the diagnosis of EVA (p<0.001), while the absence of this appearance was significant for the exclusion of EVA (p<0.001). There was no significant difference between the measurements on CT and MRI. There was a perfect correlation between the observers for measurements.
CONCLUSION
MRI can be used as an initial imaging technique in children with suspicion of EVA to reduce radiation exposure.
目的
本研究旨在评估磁共振成像（MRI）与计算机断层扫描（CT）相比，在检测儿童扩大的前庭导水管（EVA）方面的诊断有效性。
方法
回顾性评估2013年至2020年间因听力损失接受颞骨CT和MRI检查的123名儿童。所有CT和MRI图像均由两名儿科放射科医生根据EVA的瓦尔瓦索里和辛辛那提标准进行检查。记录前庭导水管CT和MRI的影像学表现。两名儿科放射科医生对CT和MRI上的EVA进行测量。此外，一名耳鼻喉科医生独立进行测量。计算MRI与CT相比检测EVA的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。研究CT和MRI测量值之间的差异。评估测量结果的观察者间一致性。
结果
123名儿童（65名男孩和58名女孩）的平均年龄为50.18±50.40个月。对123名儿童的246只耳朵进行了评估。在CT图像上，根据辛辛那提标准，246只耳朵中有28只（11.3%）存在EVA，根据瓦尔瓦索里标准，246只耳朵中有27只（10.9%）存在EVA。对于辛辛那提标准，MRI的敏感性、特异性、PPD和NPD率分别为100%、99%、92.8%和100%，对于瓦尔瓦索里标准，分别为100%、97.3%、77.7%和100%。根据不使用测量的视觉评估，前庭导水管的扩大外观对EVA的诊断具有显著意义（p<0.001），而没有这种外观对排除EVA具有显著意义（p<0.001）。CT和MRI测量值之间无显著差异。观察者之间的测量结果具有完美的相关性。
结论
对于疑似EVA的儿童，MRI可作为初始成像技术以减少辐射暴露。
Zotero 插件