Lesion-specific prognosis by magnetic resonance imaging in sudden sensorineural hearing loss

Abstract

Background

High signals in the inner ear of idiopathic sudden sensorineural hearing loss (ISSNHL) on magnetic resonance imaging (MRI) have been reported, but no quantitative evaluation has yet been done.

Objectives

To evaluate hearing outcomes and cochlear signal intensities on 3-T heavily T₂-weighted three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (hT₂W-3D-FLAIR) in patients with ISSNHL.

Materials and methods

Twenty-nine patients with ISSNHL were included. Patients underwent hT₂W-3D-FLAIR with intravenous gadolinium injection and pure tone audiometry (PTA) at initial visits and 3 months later. Signal intensity ratios (SIRs) were measured in the basal or apical-middle turns of the affected cochlea. A statistical analysis of relationships between SIRs and the average hearing levels (HLs) at low (125, 250, and 500 Hz) and high (2, 4, and 8 kHz) tone frequencies was performed.

Results

Hearing improvements at high-tone frequencies in ears with HLs ≥60 dB were significantly worse in those with high SIRs at the basal turns on pre-contrast images. Similarly, hearing improvements at low-tone frequencies in ears with HLs ≥60 dB were significantly worse in those with high SIRs at the apical-middle turns on post-contrast images.

Conclusions and significance

High SIRs on hT₂W-3D-FLAIR indicate cochlear disturbances with severe ISSNHL and could provide lesion-specific prognostic information.

Chinese abstract

背景：特发性突然感觉神经性听力损失（ISSNHL）的内耳中有磁共振成像（MRI）高信号的报道, 但尚未对此进行定量评估。

目的：评估ISSNHL患者的3-T重度T2加权三维流体衰减反转恢复磁共振成像（hT2W-3D-FLAIR）的听力结果和耳蜗信号强度。

材料和方法：共纳入29例ISSNHL患者。患者在初次就诊时和3个月后接受静脉注射g的hT2W3D-FLAIR和纯音测听（PTA）。在患病耳蜗基底的基部或根尖处测量信号强度比（SIR）。 SIR与平均听力水平（HLs）之间关系的统计分析在低（125、250和500 Hz）和高（2、4和8 kHz）音调频率下进行。

结果：HLs ≥ 60 dB的耳朵在高音频率下的听力改善与基部预对比图像上高SIR的耳朵相比显着更糟。同样, HLs ≥ 60 dB的耳朵在低音频率下的听力改善与顶端-中部后对比图像上高SIR耳朵相比明显较差。

结论和意义：hT2W-3D-FLAIR上的高SIR提示严重的ISSNHL的耳蜗疾病, 可提供特定病变的预后信息。

Keywords:

• Idiopathic sudden sensorineural hearing loss
• heavily T2-weighted 3D-FLAIR
• quantitative analysis

Disclosure statement

The authors report no conflict of interest.