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Acuerdo de hidrops vestibular sustancialmente más alto en pacientes mayores evaluado por resonancia magnética sin
Shinji Naganawa1, Rintaro Ito1, Yutaka Kato1
1Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya Aichi, Japan.
Resumen
El acuerdo en la clasificación de las hidropsias endolimfáticas (EH) mediante resonancia magnética difiere según la edad y la ubicación. Los pacientes mayores muestran un mejor acuerdo con la resonancia magnética sin contraste, mientras que los pacientes más jóvenes requieren precaución debido a posibles malas interpretaciones.
Área de la Ciencia:
- Radiología Radiología.
- Imágenes médicas de imágenes médicas.
- La otorrinolaringología otorrinolaringología.
Sus antecedentes:
- La hidropsia endolimfática (EH) es una afección que afecta al oído interno, a menudo diagnosticada mediante resonancia magnética.
- La técnica HYDROPS (HYbriD de imagen invertida de señal positiva de endolinfa e imagen nativa de señal positiva de perilinfa) ofrece secuencias de resonancia magnética sin contraste y mejoradas con contraste.
- Evaluar el acuerdo entre estas técnicas y la influencia de la edad del paciente es crucial para un diagnóstico preciso.
Objetivo del estudio:
- Investigar el acuerdo en la gradación de hidrops endolimfáticos (EH) entre las técnicas de resonancia magnética HYDROPS sin contraste y las técnicas de resonancia magnética con contraste mejorado.
- Para aclarar el efecto de la edad del paciente en la concordancia entre los dos métodos de RM.
Principales métodos:
- Análisis retrospectivo de 24 oídos de 12 pacientes con sospecha de EH.
- Los pacientes se sometieron a resonancia magnética 3T tanto sin contraste como 4 horas después del contraste.
- La clasificación de la EH utilizó la escala de Nakashima; el acuerdo se evaluó a través de la kappa ponderada de Cohen (κ), con análisis de subgrupos por edad.
Principales resultados:
- En general, hay un acuerdo justo entre los métodos sin contraste y los mejorados con contraste tanto para la cóclea (κ = 0,343) como para el vestíbulo (κ = 0,398).
- Diferencia significativa relacionada con la edad en el acuerdo vestibular (P = 0,005): acuerdo sustancial en pacientes mayores (κ = 0,795), ligeramente acuerdo en pacientes más jóvenes (κ = 0,113).
- El método sin contraste mostró una relación contraste-ruido significativamente más baja que el método con contraste mejorado.
Conclusiones:
- El acuerdo de MRI para la evaluación de EH depende de la ubicación (coclea vs. vestíbulo) y la edad del paciente.
- Los pacientes mayores exhiben una mayor concordancia, lo que sugiere que los cambios fisiológicos relacionados con la edad ayudan a la visualización sin contraste.
- Se recomienda precaución para los pacientes más jóvenes debido a la posible sobreestimación de la EH vestibular y la subestimación de la EH coclear con MRI sin contraste.
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