Revisiting the relationship of three-dimensional fluid attenuation inversion recovery imaging and hearing outcomes in adults with idiopathic unilateral sudden sensorineural hearing loss
Revisiting the relationship of three-dimensional fluid attenuation inversion recovery imaging and hearing outcomes in adults with idiopathic unilateral sudden sensorineural hearing loss
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DOI：
10.1016/j.ejrad.2016.10.005
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发表时间：
2016-12-01
影响因子：
3.3
通讯作者：
Hung, Sheng-Che
中科院分区：
文献类型：
--
作者：
Liao, Wen-Huei;Wu, Hsiu-Mei;Hung, Sheng-Che
背景和目的：三维液体衰减反转恢复（3D FLAIR）可显示特发性突发性感音神经性听力损失（ISSNHL）患者内耳的高信号，但这一发现与预后的相关性仍存在争议。材料与方法：77例成人ISSNHL患者行MRI平扫FLAIR、稳态采集快速成像（FIESTA-C）、增强后T1 WI和增强后FLAIR扫描。对所有患者的双侧耳蜗高信号范围和程度进行评估，并计算患耳与正常耳之间的不对称比率。MRI结果之间的关系，包括程度和不对称的异常耳蜗高信号，FLAIR增强的程度，和临床信息，包括年龄，前庭症状，基线听力损失，和最终的听力outcomes.Results：54例患者（28名男性，年龄，52.1 +/- 15.5岁）被纳入我们的研究。增强前和增强后FLAIR的耳蜗信号不对称率（79.6%和68.5%）高于FIESTA-C（61.1%）和T1 WI（51.9%）（p < 0.001）。年龄、基线听力损失、增强前后FLAIR的高信号范围和不对称率均与最终听力结果相关。多因素分析显示，年龄和耳蜗高信号范围是最终听力结果的最重要预测因素。结论：3DFLAIR技术对非对称性耳蜗信号异常具有较高的敏感性。FLAIR信号的不对称性和耳蜗外高信号的存在表明预后较差。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Background and purpose: Three-dimensional fluid attenuation inversion recovery (3D FLAIR) may demonstrate high signal in the inner ears of patients with idiopathic sudden sensorineural hearing loss (ISSNHL), but the correlations of this finding with outcomes are still controversial. Here we compared 4 3D MRI sequences with the outcomes of patients with ISSNHL.Materials and methods: 77 adult patients with ISSNHL underwent MRI with pre contrast FLAIR, fast imaging employing steady-state acquisition images (FIESTA-C), post contrast T1WI and post contrast FLAIR. The extent and degree of high signal in both cochleas were evaluated in all patients, and asymmetry ratios between the affected ears and the normal ones were calculated. The relationships among MRI findings, including extent and asymmetry of abnormal cochlear high signals, degree of FLAIR enhancement, and clinical information, including age, vestibular symptoms, baseline hearing loss, and final hearing outcomes were analyzed.Results: 54 patients (28 men; age, 52.1 +/- 15.5 years) were included in our study. Asymmetric cochlear signal intensities were more frequently observed in pre contrast and post contrast FLAIR (79.6% and 68.5%) than in FIESTA-C (61.1%) and T1WI (51.9%) (p < 0.001). Age, baseline hearing loss, extent of high signal and asymmetry ratios of pre contrast and post contrast FLAIR were all correlated with final hearing outcomes. In multivariate analysis, age and the extent of high signals were the most significant predictors of final hearing outcomes.Conclusion: 3D FLAIR provides a higher sensitivity in detecting the asymmetric cochlear signal abnormality. The more asymmetric FLAIR signals and presence of high signals beyond cochlea indicated a poorer prognosis. (C) 2016 Elsevier Ireland Ltd. All rights reserved.