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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Diagnostic Yield of MRI for Sensorineural Hearing Loss - An Audit
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Diagnostic Yield of MRI for Sensorineural Hearing Loss - An Audit

机译：用于感应性听力损失MRI的诊断产量 - 审计

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Purpose: Contrast-enhanced magnetic resonance imaging (CEMRI) of the head is frequently employed in investigations of sensorineural hearing loss (SNHL). The yield of these studies is perceptibly low and seemingly at odds with the aims of wise resource allocation and risk reduction within the Canadian healthcare system. The purpose of our study was to audit the use and diagnostic yield of CEMRI for the clinical indication of SNHL in our institution and to identify characteristics that may be leveraged to improve yield and optimize resource utilization. Materials and methods: The charts of 500 consecutive patients who underwent CEMRI of internal auditory canal for SNHL were categorized as cases with relevant positive findings on CEMRI and those without relevant findings. Demographics, presenting symptoms, interventions and responses, ordering physicians, and investigations performed prior to CEMRI testing were recorded. Chi-squared test and t-test were used to compare proportions and means, respectively. Results: CEMRI studies revealed relevant findings in 20 (6.2%) of 324 subjects meeting the inclusion criteria. Pre-CEMRI testing beyond audiometry was conducted in 35% of those with relevant positive findings compared to 7.3% of those without (p < 0.001). Auditory brainstem response/ vestibular-evoked myogenic potentials were abnormal in 35% of those with relevant CEMRI findings compared to 6.3% of those without (p < 0.001). Conclusion: CEMRI is a valuable tool for assessing potential causes of SNHL, but small diagnostic yield at present needs justification for contrast injection for this indication. Our findings suggest preferred referral from otolaryngologists exclusively, and implementation of a non-contrast MRI for SNHL may be a better diagnostic tool.
机译：目的：头部对比增强磁共振成像（CEMRI）常用于感音神经性耳聋（SNHL）的研究。这些研究的产出明显较低，似乎与加拿大医疗体系内明智的资源分配和降低风险的目标不符。我们研究的目的是审核CEMRI在我们研究所的SNHL临床指征中的使用和诊断率，并确定可用于提高产量和优化资源利用率的特征。材料和方法：连续500例因SNHL接受内耳道CEMRI检查的患者的图表分为CEMRI相关阳性和无相关结果的患者。记录人口统计数据、症状表现、干预措施和反应、医生医嘱以及CEMRI检测前进行的调查。卡方检验和t检验分别用于比较比例和平均值。结果：CEMRI研究显示，324名受试者中有20名（6.2%）符合纳入标准。有相关阳性结果的患者中有35%进行了CEMRI前测听以外的测试，而无相关结果的患者中有7.3%进行了CEMRI前测听（p<0.001）。在有相关CEMRI检查结果的患者中，听觉脑干反应/前庭诱发肌源性电位异常率为35%，而无相关CEMRI检查结果的患者中，听觉脑干反应/前庭诱发肌源性电位异常率为6.3%（p<0.001）。结论：CEMRI是评估SNHL潜在病因的一个有价值的工具，但目前的诊断率很低，需要为该适应症进行对比剂注射。我们的研究结果表明，耳鼻喉科医生优先推荐SNHL，而对SNHL进行非对比MRI检查可能是更好的诊断工具。

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