Department of Otolaryngology Head Neck Surgery, CHU Gabriel Montpied, Clermont-Ferrand, France.
Department of Radiology, CHU Gabriel Montpied, Clermont-Ferrand, France.
Eur Arch Otorhinolaryngol. 2022 Oct;279(10):4883-4891. doi: 10.1007/s00405-022-07328-4. Epub 2022 Mar 14.
The aim of the study was to assess a correlation between MRI labyrinthine changes detected with IV-gadolinium optimized high-resolution 3D-FLAIR sequences 4 h after injection (OPT4-3DFLAIR) and the type of SSNHL, in terms of frequency alteration and severity.
This was a prospective monocentric study achieved from July 2019 to December 2020. The inclusion criterion was acute hearing loss of at least 30 dB over three contiguous frequencies occurring within a 72-h period, documented by a pure-tone audiometry (PTA). The primary endpoint was the visual assessment of hyperintensity in labyrinthine structures on OPT4-3DFLAIR performed on 3T MRI.
Thirty-six affected ears were included (20 men, 15 women; mean age: 54.5 ± 16.3 years) with 69.4% full-spectrum hearing loss. The median hearing loss, expressed as median and interquartile range [IQR] was 91 dB [74-120], with 47.2% of concomitant acute vestibular syndrome. Pathological signal was found in 26 out of 36 ears (72.2%). Basal turn enhancement was found in all abnormal MRIs, with 73.1% of apical turn enhancement and 50% of vestibular enhancement. Seventeen on 19 cases (89.5%) with apical involvement on MRI had low-frequency hearing loss. Vestibular involvement on MRI was significantly associated with a wider frequency range of hearing loss (p = 0.0002) and the severity of SSNHL (84.5 [71.7-92.5] dB versus 120 [85.8-120] dB, p = 0.0158).
This report shows that in pathological MRI in SSNHL, a pathologic cochlear base signal is always detected, a cochlear apical turn enhancement matches with low-tone impairment, and a pathological signal within the posterior labyrinth is associated with an impairment of all frequencies and the severity of SSNHL.
本研究旨在评估注射后 4 小时（OPT4-3DFLAIR）使用 IV 钆优化高分辨率 3D-FLAIR 序列检测到的 MRI 迷路变化与 SSNHL 类型之间的相关性，具体涉及频率改变和严重程度。
这是一项前瞻性单中心研究，于 2019 年 7 月至 2020 年 12 月进行。纳入标准为在 72 小时内出现至少 30dB 的三个连续频率的急性听力损失，通过纯音听阈测试（PTA）记录。主要终点是对 3T MRI 上的 OPT4-3DFLAIR 进行的迷路结构高信号的视觉评估。
共纳入 36 只受累耳（20 名男性，15 名女性；平均年龄：54.5±16.3 岁），其中 69.4% 为全频听力损失。听力损失中位数表示为中位数和四分位距 [IQR]，为 91dB [74-120]，47.2% 伴有急性前庭综合征。36 只耳中有 26 只（72.2%）发现病理性信号。所有异常 MRI 均发现基底转增强，其中 73.1% 发现顶端转增强，50% 发现前庭增强。19 例中有 17 例（89.5%）MRI 发现顶端受累，这些患者低频听力损失。MRI 发现前庭受累与听力损失频率范围更宽（p=0.0002）和 SSNHL 严重程度显著相关（84.5[71.7-92.5]dB 与 120[85.8-120]dB，p=0.0158）。
本报告表明，在 SSNHL 的病理性 MRI 中，总是可以检测到病理性耳蜗基底信号，耳蜗顶端转增强与低频听力损失相匹配，而后迷路的病理性信号与所有频率的听力损失和 SSNHL 的严重程度相关。
