Burck Iris, Drath Franziska, Albrecht Moritz H, D Angelo Tommaso, Ackermann Hanns, Scholtz Jan-Erik, Yel Ibrahim, Stöver Timo, Helbig Silke, Vogl Thomas J, Kaltenbach Benjamin, Scholtz Jan-Erik
Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt 60590, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt 60590, Germany.
Acad Radiol. 2022 Mar;29 Suppl 3:S88-S97. doi: 10.1016/j.acra.2021.02.025. Epub 2021 Apr 8.
To evaluate cone-beam computed-tomography (CBCT) images of the temporal bone for radiological delineation, metal artifacts, and accuracy for localization of six different electrode arrays after cochlear device implantation.
This retrospective study included 116 patients who underwent CBCT (120kV, 7.1mA) within 24 hours after cochlear device implantation. Exclusion criteria were anatomical abnormalities, and electrode misinsertion. Six different CI electrodes were implanted: Advanced Bionics HiFocus Mid-Scala, Cochlear Contour Advance, Cochlear Slim-Straight, Cochlear Slim-Modiolar, MED-EL Flex 24 and MED-EL Flex 28. Two radiologists rated independently presence of metal artifacts, overall image quality, as well as dedicated visualization of the osseous spiral lamina, inner and outer cochlear wall, single electrode contacts, and electrode position using 5-point-Likert scales. Inter-rater agreement was calculated by using Cohen's kappa and intraclass correlation.
Of 116 patients, 94 (81.0%; 56.1 ± 16.9 years; age range, 13-86 years; 49 [52.1%] females) were included in the study. Overall image quality was rated good for all electrode models without significant differences (p = 0.061). Depiction of electrode contacts was rated significantly better for Advanced Bionics HiFocus Mid-Scala, Cochlear Slim-Straight, and MED-EL Flex 24 and 28 compared to Cochlear Contour Advance and Slim-Modiolar (p < 0.001). Depiction of the osseous spiral lamina (p = 0.20), inner (p = 0.42) and outer cochlear wall (p = 0.35), metal artifacts (p = 0.18), and electrode position (p = 0.31) did not show significant differences between electrode models. Inter-rater agreement varied from substantial to almost perfect (0.70-0.93).
CBCT provides excellent visualization of all evaluated CI electrode types, in particular electrode arrays with greater spacing between contacts and contact size allow improved radiologic evaluation.
评估颞骨的锥形束计算机断层扫描（CBCT）图像，以观察其对六种不同电极阵列在人工耳蜗植入后的放射学描绘、金属伪影及定位准确性。
本回顾性研究纳入了116例在人工耳蜗植入后24小时内接受CBCT检查（120kV，7.1mA）的患者。排除标准为解剖结构异常和电极误插入。植入了六种不同的人工耳蜗电极：Advanced Bionics HiFocus Mid-Scala、Cochlear Contour Advance、Cochlear Slim-Straight、Cochlear Slim-Modiolar、MED-EL Flex 24和MED-EL Flex 28。两名放射科医生使用5分李克特量表独立评估金属伪影的存在、整体图像质量，以及骨螺旋板、耳蜗内外壁、单个电极触点和电极位置的专门可视化情况。通过使用科恩kappa系数和组内相关性计算评分者间的一致性。
116例患者中，94例（81.0%；年龄56.1±16.9岁；年龄范围13 - 86岁；49例[52.1%]为女性）纳入研究。所有电极模型的整体图像质量均被评为良好，无显著差异（p = 0.061）。与Cochlear Contour Advance和Slim-Modiolar相比，Advanced Bionics HiFocus Mid-Scala、Cochlear Slim-Straight以及MED-EL Flex 24和28的电极触点描绘被评为明显更好（p < 0.001）。电极模型之间在骨螺旋板（p = 0.20）、耳蜗内壁（p = 0.42）和外壁（p = 0.35）、金属伪影（p = 0.18）以及电极位置（p = 0.31）的描绘上未显示出显著差异。评分者间的一致性从实质性到几乎完美不等（0.70 - 0.93）。
CBCT能很好地显示所有评估的人工耳蜗电极类型，特别是触点间距和触点尺寸较大的电极阵列，有助于改善放射学评估。
