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Optimizing CT for the evaluation of vestibular aqueduct enlargement:Inter-rater reproducibility and predictive value of reformatted CT measurements

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Journal of Otology 2015年第1期10卷 13-17页

作者： misun hwang Ryan Marovich Samuel S.Shin David Chi Barton F.Branstetter IV Department of Radiology University of Pittsburgh Medical Center Department of Otolaryngology University of Pittsburgh Medical Center Department of Neurosurgery University of Pittsburgh Medical Center Department of Otolaryngology Children's Hospital of Pittsburgh

Enlarged vestibular aqueduct(EVA), the most frequent identifiable cause of congenital hearing loss, is evaluated with high-definition multidetector CT in the axial plane. Our purpose was to determine which reformatted CT measurements are most reproducible. Seven multiplanar reformatted images were created for each of the 64 temporal bones in patients with EVA. Intraclass correlation coefficients(ICC) were used to assess inter-observer variability, and both linear regression and ROC analyses were used to compare the measurements with severity of hearing loss, as assessed by pure tone audiometry. All seven measurements had excellent inter-observer variability, with average-measure ICC ranging from 0.92 to 0.98. There was no statistically significant correlation between the radiologic degree of aqueduct enlargement and severity of hearing loss using any of the seven measurements; ROC analyses revealed areas under the curves ranging from 0.57 to 0.73. Optimal accuracy was obtained with a threshold of 1.75 mm as measured at the aqueductal aperture in the P€oschl plane, with sensitivity of 0.75 and specificity of0.63. Although the radiologic measurement may not serve as a reliable tool for assessing severity of EVA, P€oschl plane reformatting has proven to be better than conventional axial acquisition plane for identifying patients with clinically significant hearing loss.

关键词： Enlarged vestibular aqueduct Hearing loss Computed

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