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Diagnostic yield of MRI for pediatric hearing loss: a systematic review
Bart Kachniarz1, Jenny X Chen1, Sapideh Gilani1
1Harvard Medical School, Boston, Massachusetts, USA.
Objective:
To perform a systematic review to analyze the diagnostic yield of magnetic resonance imaging (MRI) for pediatric hearing loss, including comparison to computed tomography (CT) and subgroup evaluation according to impairment severity and specific diagnostic findings (cochlear anomalies, enlarged vestibular aqueduct, cochlear nerve abnormalities, and brain findings).
Data Sources:
Pubmed, EMBASE, and the Cochrane library were assessed from their inception through December 2013. Manual searches were also performed, and topic experts were contacted.
Review Methods:
Data from studies describing the use of MRI with or without comparison to CT in the diagnostic evaluation of pediatric patients with hearing loss were evaluated, according to a priori inclusion/exclusion criteria. Two independent evaluators corroborated the extracted data. Heterogeneity was evaluated according to the I(2) statistic.
Results:
There were 29 studies that evaluated 2434 patients with MRIs and 1451 patients with CTs that met inclusion/exclusion criteria. There was a wide range of diagnostic yield from MRI. Heterogeneity among studies was substantial but improved with subgroup analysis. Meta-analysis of yield differences demonstrated that CT had a greater yield than MRI for enlarged vestibular aqueduct (yield difference 16.7% [95% CI, 9.1%-24.4%]) and a borderline advantage for cochlear anomalies (4.7% [95% CI, 0.1%-9.5%]). Studies were more likely to report brain findings with MRI.
Conclusions:
These data may be utilized in concert with that from studies of risks of MRI and risk/yield of CT to inform the choice of diagnostic testing.
Insights
Magnetic resonance imaging (MRI) and computed tomography (CT) have varying diagnostic yields for pediatric hearing loss. CT showed a higher yield for enlarged vestibular aqueduct and cochlear anomalies, while MRI was better for brain findings.
Area of Science:
- Otolaryngology
- Radiology
- Pediatrics
Background:
- Pediatric hearing loss diagnosis requires accurate imaging.
- Magnetic resonance imaging (MRI) and computed tomography (CT) are used, but their comparative diagnostic yields are not fully established.
Purpose of the Study:
- To systematically review and analyze the diagnostic yield of MRI for pediatric hearing loss.
- To compare MRI with CT and evaluate subgroups based on impairment severity and specific findings.
Main Methods:
- Systematic review of PubMed, EMBASE, and Cochrane Library (inception to Dec 2013).
- Inclusion of studies evaluating MRI with or without CT for pediatric hearing loss.
- Meta-analysis of diagnostic yield differences and heterogeneity assessment.
Main Results:
- 29 studies (2434 patients MRI, 1451 patients CT) met criteria.
- CT demonstrated higher yield for enlarged vestibular aqueduct (16.7%) and cochlear anomalies (4.7%).
- MRI was more likely to report brain findings.
Conclusions:
- Imaging choice for pediatric hearing loss should consider specific findings and modality yields.
- CT may be preferred for certain cochlear and vestibular anomalies, while MRI excels in detecting brain abnormalities.
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