MRI during cochlear implant assessment: should we image the whole brain?
MRI during cochlear implant assessment: should we image the whole brain?
OBJECTIVES: Magnetic resonance imaging (MRI) is a standard part of a cochlear implant assessment in most centres. While there is ample literature on the temporal bone-specific imaging that is required, the role of whole brain imaging has not been as fully studied. We present the first report of the incidence of associated brain abnormalities in the whole cochlear implant population, including adults and consider their significance.
METHODS: We retrospectively reviewed 51 (12 adults and 39 children) sequential cases since we added whole brain MRI sequences to our cochlear implant assessment protocol. We reviewed the scans for abnormalities of the cochlea and cochlear nerve and a neuroradiologist reviewed the images of the whole brain sequences for further abnormalities.
RESULTS: We identified abnormalities on the whole brain sequences in 21 (41%) of these patients, 5 of 12 adults (42%) and 16 of 39 children (41%). Thirty-six (71%) patients subsequently had at least one implant inserted, 13 with abnormalities on whole brain MRI (36%) and 23 without. Of the 15 patients who did not undergo subsequent implantation, 8 had positive findings on their whole brain MRI sequence (53%). There was no statistical difference in the probability of finding an abnormality on the whole brain MRI between those who did and those who did not go on to have an implant (P = 0.35). There were abnormalities within the inner ear in five patients.
DISCUSSION: The abnormalities detected on the whole brain images are heterogenous and of wide ranging clinical significance ranging from truly incidental findings to abnormalities that are so severe that they may predict a very poor prognosis such that an implant may contribute little.
Adult, Aged, Auditory Pathways/abnormalities, Brain/abnormalities, Brain Diseases/diagnosis, Cochlear Implantation/methods, Cochlear Nerve/abnormalities, Contraindications, Ear, Inner/abnormalities, Female, Humans, Incidental Findings, Infant, Magnetic Resonance Imaging/methods, Male, Prognosis, Retrospective Studies, Temporal Bone/pathology
2-6
Proctor, Robin D
32e56297-646a-4c79-85a0-18163e39ad31
Gawne-Cain, Mary L
965db1c3-79ca-455a-82e0-1cdc9b8042c4
Eyles, Julie
183486b3-50e3-4dc2-a4cb-ab04023cb83e
Mitchell, Timothy E
46015cca-9f60-48ba-b799-8fd5650699d7
Batty, Vincent B
c64eeef6-e54b-4f36-8ac9-2ab23b17ecc4
18 July 2013
Proctor, Robin D
32e56297-646a-4c79-85a0-18163e39ad31
Gawne-Cain, Mary L
965db1c3-79ca-455a-82e0-1cdc9b8042c4
Eyles, Julie
183486b3-50e3-4dc2-a4cb-ab04023cb83e
Mitchell, Timothy E
46015cca-9f60-48ba-b799-8fd5650699d7
Batty, Vincent B
c64eeef6-e54b-4f36-8ac9-2ab23b17ecc4
Proctor, Robin D, Gawne-Cain, Mary L, Eyles, Julie, Mitchell, Timothy E and Batty, Vincent B
(2013)
MRI during cochlear implant assessment: should we image the whole brain?
Cochlear Implants International, 14 (1), .
(doi:10.1179/1754762811Y.0000000029).
Abstract
OBJECTIVES: Magnetic resonance imaging (MRI) is a standard part of a cochlear implant assessment in most centres. While there is ample literature on the temporal bone-specific imaging that is required, the role of whole brain imaging has not been as fully studied. We present the first report of the incidence of associated brain abnormalities in the whole cochlear implant population, including adults and consider their significance.
METHODS: We retrospectively reviewed 51 (12 adults and 39 children) sequential cases since we added whole brain MRI sequences to our cochlear implant assessment protocol. We reviewed the scans for abnormalities of the cochlea and cochlear nerve and a neuroradiologist reviewed the images of the whole brain sequences for further abnormalities.
RESULTS: We identified abnormalities on the whole brain sequences in 21 (41%) of these patients, 5 of 12 adults (42%) and 16 of 39 children (41%). Thirty-six (71%) patients subsequently had at least one implant inserted, 13 with abnormalities on whole brain MRI (36%) and 23 without. Of the 15 patients who did not undergo subsequent implantation, 8 had positive findings on their whole brain MRI sequence (53%). There was no statistical difference in the probability of finding an abnormality on the whole brain MRI between those who did and those who did not go on to have an implant (P = 0.35). There were abnormalities within the inner ear in five patients.
DISCUSSION: The abnormalities detected on the whole brain images are heterogenous and of wide ranging clinical significance ranging from truly incidental findings to abnormalities that are so severe that they may predict a very poor prognosis such that an implant may contribute little.
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Accepted/In Press date: October 2011
Published date: 18 July 2013
Keywords:
Adult, Aged, Auditory Pathways/abnormalities, Brain/abnormalities, Brain Diseases/diagnosis, Cochlear Implantation/methods, Cochlear Nerve/abnormalities, Contraindications, Ear, Inner/abnormalities, Female, Humans, Incidental Findings, Infant, Magnetic Resonance Imaging/methods, Male, Prognosis, Retrospective Studies, Temporal Bone/pathology
Organisations:
Human Sciences Group
Identifiers
Local EPrints ID: 202321
URI: http://eprints.soton.ac.uk/id/eprint/202321
ISSN: 1467-0100
PURE UUID: e3a50f12-2fc2-4efe-b55a-8c2b02154073
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Date deposited: 04 Nov 2011 16:45
Last modified: 14 Mar 2024 04:23
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Contributors
Author:
Robin D Proctor
Author:
Mary L Gawne-Cain
Author:
Julie Eyles
Author:
Timothy E Mitchell
Author:
Vincent B Batty
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