Swarup Anurita, Karakkandy Vinusree, Chappity Preetam, Naik Suprava, Behera Sanjay Kumar, Parida Pradipta Kumar, Grover Mohnish, Gupta Gaurav, Giri Prajna Paramita, Sarkar Saurav, Pradhan Pradeep, Samal Dillip Kumar, Kallyadan Veetil Aswathi, Adhikari Asutosh, Nayak Saurav
Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
J Otol. 2023 Oct;18(4):208-213. doi: 10.1016/j.joto.2023.08.001. Epub 2023 Aug 23.
Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are commonly employed in pre-operative evaluation for cochlear implant surgery. However, with a decrease in the age of implantation, even minor radiation exposure can cause detrimental effects on children over their lifetime. The current study compares different cochlear measurements from CT and MRI scans and evaluates the feasibility of using only an MRI scan for radiological evaluation before cochlear implantation.
A longitudinal observational study was conducted on 94 ears/47 children, employing CT and MRI scans. The CT and MRI scan measurements include, A value, B value, Cochlear duct length (CDL), two-turn cochlear length, alpha and beta angles to look for cochlear orientation. Cochlear nerve diameter was measured using MRI. The values were compared.
The mean difference between measurements from CT and MRI scans for A value, B value, CDL, and two-turn cochlear length values was 0.567 ± 0.413 mm, 0.406 ± 0.368 mm, 2.365 ± 1.675 mm, and 2.063 ± 1.477 mm respectively without any significant difference. The alpha and beta angle measures were comparable, with no statistically significant difference.
The study suggests that MRI scans can be the only radiological investigation needed with no radiation risk and reduces the cost of cochlear implant program in the paediatric population. There is no significant difference between the measurements obtained from CT and MRI scans. However, observed discrepancies in cochlear measurements across different populations require regionally or race-specific standardized values to ensure accurate diagnosis and precision in cochlear implant surgery. This aspect must be addressed to ensure positive outcomes for patients.
计算机断层扫描（CT）和磁共振成像（MRI）常用于人工耳蜗植入手术的术前评估。然而，随着植入年龄的降低，即使是少量的辐射暴露也可能在儿童的一生中造成有害影响。本研究比较了CT和MRI扫描中不同的耳蜗测量值，并评估了在人工耳蜗植入术前仅使用MRI扫描进行放射学评估的可行性。
对94只耳/47名儿童进行了一项纵向观察性研究，采用CT和MRI扫描。CT和MRI扫描测量包括A值、B值、蜗管长度（CDL）、两圈耳蜗长度、用于观察耳蜗方向的α角和β角。使用MRI测量蜗神经直径。对这些值进行比较。
CT和MRI扫描测量的A值、B值、CDL和两圈耳蜗长度值之间的平均差异分别为0.567±0.413mm、0.406±0.368mm、2.365±1.675mm和2.063±1.477mm，无显著差异。α角和β角测量结果具有可比性，无统计学显著差异。
该研究表明，MRI扫描可以是唯一需要的放射学检查，无辐射风险，并降低了儿科人群人工耳蜗植入项目的成本。CT和MRI扫描获得的测量值之间无显著差异。然而，不同人群耳蜗测量中观察到的差异需要区域或种族特异性的标准化值，以确保人工耳蜗植入手术的准确诊断和精确性。必须解决这一方面的问题，以确保患者获得良好的治疗效果。
