Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA.
Texas A&M University Health and Science Center, Bryan, TX, USA.
Int J Pediatr Otorhinolaryngol. 2021 Nov;150:110936. doi: 10.1016/j.ijporl.2021.110936. Epub 2021 Oct 11.
To determine if Gadolinium-based enhanced Magnetic Resonance Imaging (GdMRI) can be used to predict sensorineural hearing loss (SNHL) in pediatric patients diagnosed with bacterial meningitis.
Design: Retrospective chart review.
Primary Children's Hospital, Salt Lake City, Utah.
and Methods: We studied forty-two pediatric patients diagnosed with bacterial meningitis who underwent brain GdMRI during their index hospital admission and for whom ear specific audiometric data were available (August 2008-July 2018). A pediatric neuroradiologist, blinded to both disease and audiometric data, rated cochlear enhancement of each GdMRI (0-3; none to markedly enhanced).
Ear specific MRI scores were statistically significantly related to ear specific hearing outcomes (p < 0.01). SNHL occurred in 19 out of 82 ears (12 out of 42 patients; 2 ears were excluded due to pre-existing SNHL in one ear and inability to read the GdMRI on the other ear). Ten of 19 ears (53%) that developed SNHL showed mild/moderate/marked enhancement (MRI score of 1, 2, or 3 respectively). Fifty-three of the 63 unaffected ears (84%) showed no enhancement (MRI score of 0). Ten of 13 (77%) ears that developed severe to profound SNHL showed mild/moderate/marked enhancement. GdMRI was 58% sensitive and 84% specific in predicting which ears would develop SNHL. GdMRI was 77% sensitive and 84% specific in identifying severe to profound SNHL.
Our study demonstrates that GdMRI is a promising tool for predicting specifically severe-profound hearing loss in pediatric patients following bacterial meningitis infection.
确定钆增强磁共振成像（GdMRI）是否可用于预测诊断为细菌性脑膜炎的儿科患者的感音神经性听力损失（SNHL）。
回顾性图表审查。
犹他州盐湖城的Primary Children's Hospital。
我们研究了 42 名诊断为细菌性脑膜炎的儿科患者，他们在入院期间接受了脑部 GdMRI 检查，并且有耳部特定的听力数据（2008 年 8 月至 2018 年 7 月）。一位儿科神经放射科医生对疾病和听力数据均不知情，对每位 GdMRI 的耳蜗增强情况进行了评分（0-3；无至明显增强）。
耳部特定的 MRI 评分与耳部特定的听力结果具有统计学显著相关性（p<0.01）。82 只耳中有 19 只（42 名患者中的 12 只；2 只因一只耳朵存在先天性 SNHL 和另一只耳朵无法读取 GdMRI 而被排除在外）发生 SNHL。19 只发生 SNHL 的耳朵中有 10 只（53%）显示轻度/中度/明显增强（MRI 评分分别为 1、2 或 3）。未受影响的 63 只耳中有 53 只（84%）无增强（MRI 评分 0）。10 只（77%）发生严重至极重度 SNHL 的耳朵显示轻度/中度/明显增强。GdMRI 在预测哪些耳朵会发生 SNHL 方面的敏感性为 58%，特异性为 84%。GdMRI 在识别严重至极重度 SNHL 方面的敏感性为 77%，特异性为 84%。
我们的研究表明，GdMRI 是一种有前途的工具，可用于预测细菌性脑膜炎感染后儿科患者的严重至极重度听力损失。
