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Lee JI, Yoon RG, Lee JH, Park JW, Yoo MH, Ahn JH, Chung JW, Park HJ. Prognostic Value of Labyrinthine 3D-FLAIR Abnormalities in Idiopathic Sudden Sensorineural Hearing Loss. AJNR Am J Neuroradiol 2016; 37:2317-2322. [PMID: 27516239 DOI: 10.3174/ajnr.a4901] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 06/16/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE According to recent research, modern MR imaging can detect the presense of abnormalities on labyrinthine. Our aim was to report the patterns and prognostic role of abnormal findings on labyrinthine imaging in patients with sudden sensorineural hearing loss. MATERIALS AND METHODS This study comprised 113 patients who were diagnosed with unilateral sudden sensorineural hearing loss and underwent 3T MR imaging, including pre-/postcontrast 3D fluid-attenuated inversion recovery and T1-weighted imaging. We analyzed abnormalities on MR imaging and correlated them with audiometric results. RESULTS Thirty-one (27%) patients showed abnormal findings on labyrinthine MR imaging in the affected ear. The initial/final hearing levels of the MRI+ group (91 ± 25/73 ± 27 dB hearing loss) were significantly worse than those of the MRI- group (69 ± 30/48 ± 24 dB hearing loss). The incidence of abnormalities on labyrinthine MR imaging was significantly lower (3 of 40, 8%) in 40 patients with initial mild-to-moderate hearing loss than in those with profound hearing loss (16 of 34, 47%). Considering hearing improvement by the Siegel criteria, the rate of complete or partial recovery was significantly higher in the MRI- group (34%) than in the MRI+ group (10%). In patients with initial severe or profound hearing loss, the MRI- group showed greater hearing improvement (38 ± 21 dB) than the MRI+ group (23 ± 22 dB). CONCLUSIONS Abnormalities on labyrinthine MR imaging were found in 27% of patients with sudden sensorineural hearing loss. The initial hearing loss was worse in the MRI+ group than in the MRI- group. In patients with initial severe and profound hearing loss, the presence of abnormalities on labyrinthine MR imaging indicated a poor prognosis.
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Affiliation(s)
- J I Lee
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
| | - R G Yoon
- Department of Radiology (R.G.Y.), Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - J H Lee
- Radiology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J W Park
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
| | - M H Yoo
- Department of Otolaryngology (M.H.Y.), College of Medicine, Kyungpook National University, Daegu, Korea
| | - J H Ahn
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
| | - J W Chung
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
| | - H J Park
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
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Eom HJ, Lee JH, Ko MS, Choi YJ, Yoon RG, Cho KJ, Nam SY, Baek JH. Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors. AJNR Am J Neuroradiol 2015; 36:1188-93. [PMID: 25678480 DOI: 10.3174/ajnr.a4247] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 11/25/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Diagnostic test accuracy studies for ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy have shown inconclusive results due to their heterogenous study designs. Our aim was to compare the diagnostic accuracy of ultrasonography-guided fine-needle aspiration versus ultrasonography-guided core needle biopsy for detecting malignant tumors of the salivary gland and for the tissue-specific diagnosis of salivary gland tumors in a single tertiary hospital. MATERIALS AND METHODS This retrospective study was approved by our institutional review board and informed consent was waived. Four hundred twelve patients who underwent ultrasonography-guided fine-needle aspiration (n = 155) or ultrasonography-guided core needle biopsy (n = 257) with subsequent surgical confirmation or clinical follow-up were enrolled. We compared the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy regarding malignant salivary gland tumors and the correct tissue-specific diagnosis of benign and malignant tumors. We also tested the difference between these procedures according to the operator's experience and lesion characteristics. RESULTS The inconclusive rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 19% and 4%, respectively (P < .001). The overall accuracy of ultrasonography-guided core needle biopsy for diagnosing malignant tumors was significantly higher than that of ultrasonography-guided fine-needle aspiration (P = .024). The correct tissue-specific diagnosis rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 95% versus 97% for benign tumors (P = .648) and 67% versus 80% for malignant tumors (P = .310). Trainees showed significantly lower accuracy with ultrasonography-guided fine-needle aspiration than with ultrasonography-guided core needle biopsy for diagnosing malignant tumors (P = .021). There was no difference between the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy according to the internal composition of the lesions. There were no complications requiring intervention or hospitalization in our patients. CONCLUSIONS Ultrasonography-guided core needle biopsy is superior to ultrasonography-guided fine-needle aspiration in detecting and characterizing malignant tumors of the salivary gland and could emerge as the diagnostic method of choice for patients presenting with a salivary gland mass.
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Affiliation(s)
- H-J Eom
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
| | - J H Lee
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
| | - M-S Ko
- Departments of Health Medicine (M.-S.K.)
| | - Y J Choi
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
| | - R G Yoon
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
| | | | - S Y Nam
- Otolaryngology (S.Y.N.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J H Baek
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
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Kim DY, Lee JH, Goh MJ, Sung YS, Choi YJ, Yoon RG, Cho SH, Ahn JH, Park HJ, Baek JH. Clinical significance of an increased cochlear 3D fluid-attenuated inversion recovery signal intensity on an MR imaging examination in patients with acoustic neuroma. AJNR Am J Neuroradiol 2014; 35:1825-9. [PMID: 24742808 DOI: 10.3174/ajnr.a3936] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The increased cochlear signal on FLAIR images in patients with acoustic neuroma is explained by an increased concentration of protein in the perilymphatic space. However, there is still debate whether there is a correlation between the increased cochlear FLAIR signal and the degree of hearing disturbance in patients with acoustic neuroma. Our aim was to investigate the clinical significance of an increased cochlear 3D FLAIR signal in patients with acoustic neuroma according to acoustic neuroma extent in a large patient cohort. MATERIALS AND METHODS This retrospective study enrolled 102 patients with acoustic neuroma, who were divided into 2 groups based on tumor location; 22 tumors were confined to the internal auditory canal and 80 extended to the cerebellopontine angle cistern. Pure tone audiometry results and hearing symptoms were obtained from medical records. The relative signal intensity of the entire cochlea to the corresponding brain stem was calculated by placing regions of interest on 3D FLAIR images. Statistical analysis was performed to compare the cochlear relative signal intensity between the internal auditory canal acoustic neuroma and the cerebellopontine angle acoustic neuroma. The correlation between the cochlear relative signal intensity and the presence of hearing symptoms or the pure tone audiometry results was investigated. RESULTS The internal auditory canal acoustic neuroma cochlea had a significantly lower relative signal intensity than the cerebellopontine angle acoustic neuroma cochlea (0.42±0.15 versus 0.60±0.17, P<.001). The relative signal intensity correlated with the audiometric findings in patients with internal auditory canal acoustic neuroma (r=0.471, P=.027) but not in patients with cerebellopontine angle acoustic neuroma (P=.427). Neither internal auditory canal acoustic neuroma nor cerebellopontine angle acoustic neuroma showed significant relative signal intensity differences, regardless of the presence of hearing symptoms (P>.5). CONCLUSIONS The cochlear signal on FLAIR images may be an additional parameter to use when monitoring the degree of functional impairment during follow-up of patients with small acoustic neuromas confined to the internal auditory canals.
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Affiliation(s)
- D Y Kim
- From the Departments of Radiology and Research Institute of Radiology (D.Y.K., J.H.L., M.J.G., Y.S.S., Y.J.C., R.G.Y., S.H.C., J.H.B.)
| | - J H Lee
- From the Departments of Radiology and Research Institute of Radiology (D.Y.K., J.H.L., M.J.G., Y.S.S., Y.J.C., R.G.Y., S.H.C., J.H.B.)
| | - M J Goh
- From the Departments of Radiology and Research Institute of Radiology (D.Y.K., J.H.L., M.J.G., Y.S.S., Y.J.C., R.G.Y., S.H.C., J.H.B.)
| | - Y S Sung
- From the Departments of Radiology and Research Institute of Radiology (D.Y.K., J.H.L., M.J.G., Y.S.S., Y.J.C., R.G.Y., S.H.C., J.H.B.)
| | - Y J Choi
- From the Departments of Radiology and Research Institute of Radiology (D.Y.K., J.H.L., M.J.G., Y.S.S., Y.J.C., R.G.Y., S.H.C., J.H.B.)
| | - R G Yoon
- From the Departments of Radiology and Research Institute of Radiology (D.Y.K., J.H.L., M.J.G., Y.S.S., Y.J.C., R.G.Y., S.H.C., J.H.B.)
| | - S H Cho
- From the Departments of Radiology and Research Institute of Radiology (D.Y.K., J.H.L., M.J.G., Y.S.S., Y.J.C., R.G.Y., S.H.C., J.H.B.)
| | - J H Ahn
- Otorhinolaryngology-Head and Neck Surgery (J.H.A., H.J.P.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H J Park
- Otorhinolaryngology-Head and Neck Surgery (J.H.A., H.J.P.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Baek
- From the Departments of Radiology and Research Institute of Radiology (D.Y.K., J.H.L., M.J.G., Y.S.S., Y.J.C., R.G.Y., S.H.C., J.H.B.)
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