扩大前庭水管患者的 45°斜位（Pöschl 位）中点前庭水管大小的回顾性研究及其与听力损失的相关性
Retrospective Review of Midpoint Vestibular Aqueduct Size in the 45° Oblique (Pöschl) Plane and Correlation with Hearing Loss in Patients with Enlarged Vestibular Aqueduct.
机构信息
From the Departments of Radiology (K.B., A.F.J., M.E.C., H.D.C., K.L.R.).
Otolaryngology (K.T., L.A.M.), Massachusetts Eye and Ear, Boston, Massachusetts.
出版信息
AJNR Am J Neuroradiol. 2021 Dec;42(12):2215-2221. doi: 10.3174/ajnr.A7339. Epub 2021 Nov 4.
BACKGROUND AND PURPOSE
Vestibular aqueduct measurements in the 45° oblique (Pöschl) plane provide a reliable depiction of the vestibular aqueduct; however, adoption among clinicians attempting to counsel patients has been limited due to the lack of correlation with audiologic measures. This study aimed to determine the correlation between midpoint vestibular aqueduct measurements in the Pöschl plane in patients with an enlarged vestibular aqueduct with repeat audiologic measures.
MATERIALS AND METHODS
Two radiologists independently measured the midpoint vestibular aqueduct diameter in the Pöschl plane reformatted from CT images in 54 pediatric patients (77 ears; mean age at first audiogram, 5 years) with an enlarged vestibular aqueduct. Four hundred nineteen audiograms were reviewed, with a median of 6 audiograms per patient (range, 3-17; mean time between first and last audiograms, 97.4 months). The correlation between midpoint vestibular aqueduct size and repeat audiologic measures (pure tone average, speech-reception threshold, and word recognition score) using a linear mixed-effects model was determined.
RESULTS
The mean midpoint vestibular aqueduct size was 1.78 mm (range, 0.81-3.46 mm). There was excellent interobserver reliability with intraclass correlation coefficients for the 2 readers measuring 0.92 (< .001). Each millimeter increase in vestibular aqueduct size was associated with an increase of 10.5 dB (= .006) in the pure tone average, an increase of 14.0 dB (= .002) in the speech-reception threshold, and a decrease in the word recognition score by 10.5% (= .05).
CONCLUSIONS
Midpoint vestibular aqueduct measurements in the Pöschl plane are highly reproducible and demonstrate a significant correlation with audiologic data in this longitudinal study with repeat measures. These data may be helpful for clinicians who are counseling patients with an enlarged vestibular aqueduct using measurements obtained in the Pöschl plane.
背景与目的
在 45°斜（Pöschl）平面上测量前庭水管可可靠地描绘前庭水管；然而，由于与听力测量缺乏相关性，试图为患者提供咨询的临床医生采用它的情况受到限制。本研究旨在确定在具有扩大的前庭水管的患者中，在 Pöschl 平面上测量的前庭水管中点测量值与重复听力测量值之间的相关性。
材料与方法
两名放射科医生独立测量了 54 名儿童患者（77 耳；首次听力检查时的平均年龄为 5 岁）的 CT 图像重建成像的 Pöschl 平面上的前庭水管中点直径。共回顾了 419 次听力图，每位患者的中位数为 6 次听力图（范围，3-17；首次和最后一次听力图之间的平均时间为 97.4 个月）。使用线性混合效应模型确定中点前庭水管大小与重复听力测量值（纯音平均听阈、言语接受阈和言语识别率）之间的相关性。
结果
平均中点前庭水管大小为 1.78 毫米（范围，0.81-3.46 毫米）。两名读者的测量值的组内相关系数为 0.92（<0.001），具有极好的观察者间可靠性。前庭水管大小每增加 1 毫米，纯音平均听阈增加 10.5 分贝（=0.006），言语接受阈增加 14.0 分贝（=0.002），言语识别率降低 10.5%（=0.05）。
结论
在这项具有重复测量的纵向研究中，Pöschl 平面上的中点前庭水管测量值具有高度可重复性，并且与听力数据显示出显著相关性。这些数据可能有助于使用 Pöschl 平面上获得的测量值为具有扩大的前庭水管的患者提供咨询的临床医生。
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