Evaluating diagnostic yield of computed tomography (CT) and magnetic resonance imaging (MRI) in pediatric unilateral sensorineural hearing loss.

Options for imaging for evaluation of pediatric patients with unilateral sensorineural hearing loss (USNHL) include computed tomography (CT) and magnetic resonance imaging (MRI). Although both CT and MR imaging provide valuable information in the evaluation of pediatric patients with USNHL, debate remains regarding which imaging modality is most ideal and should be the preferred study for these children. The objective of this study is to evaluate and compare the diagnostic yield of CT versus MRI in children with USNHL. A multi-institutional retrospective chart review was conducted. Pediatric patients with hearing loss (diagnosis codes 389.00-389.22) seen between 2010 and 2012 at three tertiary care centers were identified. Only patients with USNHL and imaging studies were reviewed and results of CT and MRI for each patient were examined and compared. Cochleovestibular or central nervous system findings known to directly correlate to SNHL were noted as positive findings on imaging. McNemar's test was used to compare patients with positive CT and MRI results. A total of 219 patients between the ages of 0-18 years with USNHL who underwent CT and/or MRI were identified. Imaging abnormalities were found in 41/96 patients who underwent MRI with overall diagnostic yield of 42.7% and 69 of 188 patients who underwent CT with overall diagnostic yield of 36.7%. For patients who underwent both imaging modalities (n = 65), there was no statistically significant difference in positive findings detected by CT vs MRI (p > 0.05). Both CT and MR imaging have similar overall diagnostic yield when used to evaluate children with USNHL. Parents and patients should be counseled regarding cost, test duration, radiation exposure, need for sedation, and diagnostic accuracy associated with each imaging modality and these factors should be considered to select the appropriate diagnostic study.

Shah J ，Pham GN ，Zhang J ，Pakanati K ，Raol N ，Ongkasuwan J ，Hopkins B ，Anne S ... -  《-》

Assessment of the Clinical Benefit of Imaging in Children With Unilateral Sensorineural Hearing Loss: A Systematic Review and Meta-analysis.

Ropers FG ，Pham ENB ，Kant SG ，Rotteveel LJC ，Rings EHHM ，Verbist BM ，Dekkers OM ... -  《-》

Imaging in pediatric bilateral sensorineural hearing loss: Diagnostic yield with computed tomography versus magnetic resonance imaging.

To evaluate the findings and compare the diagnostic yield of computed tomography (CT) versus magnetic resonance imaging (MRI) in children with bilateral sensorineural hearing loss (BSNHL). Multi-institutional retrospective review. Three tertiary referral centers. A multi-institutional retrospective chart review was performed in patients under the age of 18 years with BSNHL (diagnosis codes 389.00-389.22) who underwent both CT and MRI from 2010 to 2012. An abnormal imaging finding was defined as an abnormality of the cochleovestibular or central nervous system known to directly correlate with sensorineural hearing loss. Diagnostic yield of CT versus MRI was compared by McNemar's test. Of 2081 charts reviewed, 313 patients met inclusion criteria. The diagnostic yield of CT and MRI were 25% and 18%, respectively. Approximately one-quarter of patients had an abnormal finding on CT or MRI. The concordance rate was 92%. CT was more likely to yield an abnormal finding versus MRI (p-value = 0.0001). The most common findings on CT were cochlear and semicircular canal abnormalities. On MRI, the most common findings were cochlear nerve aplasia/hypoplasia and semicircular canal abnormalities. This study evaluates and directly compares the diagnostic yield of CT versus MRI for pediatric BSNHL. While both modalities have important and often complementary diagnostic utility, CT had superior diagnostic yield in identifying abnormalities associated with BSNHL.

Zhang J ，Sawaf T ，Anne S ，Pham GN ，Pakanati K ，Raol N ，Ongkasuwan J ，Georgopoulos R ... -  《-》

Evaluation of the Vestibular System and Etiology in Children with Unilateral Sensorineural Hearing Loss.

Birdane L ，İncesulu A ，Özüdoğru E ，Cingi C ，Caklı H ，Gürbüz MK ，Adapınar B ... -  《-》

High prevalence of abnormalities on CT and MR imaging in children with unilateral sensorineural hearing loss irrespective of age or degree of hearing loss.

Evaluation of causal abnormalities identified on CT and MR imaging in children with unilateral sensorineural hearing loss (USNHL), and the association with age and severity of hearing loss. Retrospective cohort study. Tertiary referral otology/audiology center. 102 children diagnosed with USNHL between 2006 and 2016 were included. They underwent CT and/or MR imaging for the evaluation of the etiology of their hearing loss. Radiologic abnormalities of the inner ear and brain associated with USNHL. Using CT and/or MR imaging, causal abnormalities were identified in 49%, which is higher than previously reported (25-40%). The most frequently affected site was the labyrinth (29%), followed by the cochlear nerve (9%) and brain (7%). No significant difference in the number or type of abnormalities was found for the degree of hearing loss or age categories. Imaging is essential in the etiologic analysis of USNHL because of the high prevalence of causative abnormalities that can be identified with radiology, irrespective of the patients' age or degree of hearing loss. CT and MR imaging are complementary imaging options. The ideal imaging algorithm is controversial. Based on our findings, we conclude that there is limited additional diagnostic value of simultaneous dual modality imaging over sequential diagnostics. We therefore perform a stepwise radiological workup in order to maximize the diagnostic yield while minimizing impact and costs. If the primary imaging modality does not identify a cause for USNHL, performing the alternative imaging modality should be considered. Retrospective cohort study 2b.

van Beeck Calkoen EA ，Sanchez Aliaga E ，Merkus P ，Smit CF ，van de Kamp JM ，Mulder MF ，Goverts ST ，Hensen EF ... -  《-》