Diffusion tensor imaging and auditory tractography to evaluate cochlear implant candidacy: a pilot study

Abstract

Background

Conventional radiological evaluation does not evaluate the functional status of the auditory pathway in patients scheduled for cochlear implantation (CI).

Objectives

Determine the value of diffusion tensor imaging [DTI] in the preoperative evaluation of some patients scheduled for CI.

Material and Methods

Patients with profound SNHL and inner ear and/or cochlear nerve anomalies or long standing SNHL were selected. They underwent conventional MRI images of the brain in three orthogonal planes, MR arterial spin labelling (ASL), perfusion, and DTI auditory tractography to determine functional status of the auditory pathways.

Results

Ten patients were included. Seven with bilateral SNHL, one with fluctuating hearing loss and one with long standing single sided deafness. In 8 patients the auditory pathway could be traced and functional maps could determine the side of possible better function. In the patient with progressive hearing loss DTI revealed major central pathway problems and CI was discouraged. In the patient with SSD, DTI revealed a robust intact pathway and CI was advised.

Conclusions

DTI and auditory tractography can help in outlining the functional integrity of the 33auditory pathway and assist in decision making before CI.

Chinese Abstract

背景：常规放射学评估不能评估计划进行人工耳蜗植入 (ci) 的患者的听觉通路的功能状态。

目的：确定弥散张量成像 [Dti]对有些计划接受人工耳蜗植入的患者的术前评估的价值。

材料和方法：选择了患有严重感觉神经性听力损失 （sNhl ）和内耳和/或耳蜗神经异常或长期 sNhl 的患者。 他们接受了在三个正交平面、MR 动脉自旋标记 (ASL)、灌注和 DTI 听觉纤维束造影术中大脑常规 MRI 影像, 以确定听觉通路的功能状态。

结果：共纳入 10 名患者。 七名患有双侧 sNhl, 一名患有波动性听力损失, 一名患有长期单侧耳聋。 对于 8 名患者, 可以追踪听觉通路, 功能图可以确定功能可能更好的一侧。 对于患有进行性听力损失的患者, Dti 显示出严重中枢通路问题, 因此不鼓励使用人工耳蜗植入。 对于患有 ssD 的患者, Dti 显示一个健全的完整通路, 因此建议人工耳蜗植入。

结论：Dti 和听觉纤维束成像有助于概括33 听觉通路的功能完整性, 并有助于人工耳蜗植入前作出决定。

Keywords:

• Cochlear implants
• tractography
• diffusion tensor imaging
• sensorineural hearing loss

Disclosure statement

No potential conflict of interest was reported by the author(s).