Magnetic Resonance Imaging in Prediction of Sensorineural Hearing Loss in Patients with Neuroinfections

Magnetic resonance imaging (MRI) may be useful in detecting labyrinthitis and thereby predicting the development of sensorineural hearing loss (SNHL) in adults with central nervous system (CNS) infections. We therefore investigated the coherence between brain MRI and SNHL among adults with CNS infections.

Twenty-eight patients with bacterial or viral meningitis, viral encephalitis, or Lyme neuroborreliosis, who had a brain MRI during the acute disease and pure-tone audiometry at follow-up, were included. Neuroradiologists were blinded to the audiometric outcome when rating each inner ear for MRI cochlear gadolinium enhancement using a postcontrast T1-weighted (T1W) sequence and signal intensity using a fluidattenuated inversion recovery (FLAIR) sequence. Scores were compared to the degree of SNHL.

Sensorineural hearing loss was observed in all types of infection, affecting 14 patients (26 of 56 ears). Enhancement on T1W was detected in 1 ear with normal hearing. Fluid-attenuated inversion recovery signal intensity was detected in 26 of 50 ears, of which 12 developed SNHL. The sensitivity of T1W could not be calculated. Fluid-attenuated inversion recovery had a sensitivity of 50% and specificity of 46%.

Standard brain MRI protocols are not sufficient for the detection of labyrinthitis leading to SNHL following infection of the CNS.