Diagnostic Value Of HRCT And MRI In Children With Congenital Ear Malformation

BackgroundCongenital ear malformation is a common neonatal defect,which is an important cause of congenital deafness.Due to the different deformity site and degree,the clinical manifestations of patients are significantly different.For patients with external middle ear malformation,abnormal sound conduction often occurs,causing conductive deafness;for inner ear malformation,it will cause congenital sensory neurological deafness.At present,clinically,the congenital ear malformation is mainly based on surgical examination,and the location and severity of the patient's deformity can be determined through surgery.However,surgical examinations are risky and traumatic,resulting in poor patient compliance.In recent years,imaging technologies such as CT and MRI have been continuously developed,which can replace the shortcomings of traditional X-ray tomography.Multi-slice reconstruction through multi-slice spiral CT can obtain the influence of different orientations,and can clearly show the structures of the humerus and the ossicles.The MRI can show the inner ear labyrinth and the cochlear nerve.However,there are few studies on the diagnostic effect,diagnostic efficacy and imaging characteristics of HRCT combined with MRI in congenital ear malformation.The HRCT sensitivity and specificity were 71.43% and 71.74% respectively.The sensitivity and specificity of MRI were 74.29% and 76.09%,respectively.ObjectiveTo investigate the diagnostic effect,diagnostic efficacy and imaging features of high-resolution computed tomography(HRCT)and magnetic resonance imaging(MRI)in congenital ear malformation.MethodsA total of 58 patients with congenital ear malformation who were treated in our hospital from May 2017-February 2019 were selected.All patients were finally diagnosed by surgery or follow-up.All patients underwent HRCT and MRI before diagnosis.The results of HRCT and MRI were compared with the follow-up results.The diagnostic results of HRCT and MRI in ear malformation were analyzed,and the incidence and composition ratio of various congenital ear malformations were analyzed.The ROC curve was drawn,and the diagnostic sensitivity and specificity of HRCT and MRI in the ear malformation were recorded.The US ICS ChartrEP brainstem evoked potential meter,Madsen enhanced otoacoustic emission analyzer,GSI Audera multi-frequency steady brain stem induced Potentiometer and GIC Typstar middle ear analyzer complete the hearing examination of patients with different types of congenital ear malformation;The sensitivity,specificity,positive predictive value and negative predictive value of HRCT and MRI in the diagnosis of ear malformation were recorded.The imaging features of HRCT and MRI in ear malformation were recorded and statistically analyzed.Results1.HRCT examination accuracy was 71.55%.The accuracy of MRI was 75.00%.The accuracy of HRCT and MRI combined examination was 97.41%.HRCT examination accuracy compared with MRI examination,the difference was not statistically significant(P>0.05).The diagnostic accuracy of HRCT and MRI was compared with that of combined examination respectively,and the differences were statistically significant(P ?0.05).2.The HRCT sensitivity and specificity were 71.43% and 71.74% respectively.The sensitivity and specificity of MRI were 74.29% and 76.09%,respectively.The sensitivity and specificity of HRCT combined with MRI were 97.14% and 97.83% respectively.The sensitivity and specificity of HRCT were compared with that of MRI,and the differences were not statistically significant(P >0.05).The sensitivity and specificity of HRCT and MRI were compared with the combined examination respectively,and the differences were statistically significant(P ?0.05).The positive predictive value and negative predictive value of HRCT were compared with that of MRI,and the differences were not statistically significant(P > 0.05).The positive predictive value and negative predictive value of HRCT were compared with that of MRI,and the differences were not statistically significant(P >0.05).The positive predictive value and negative predictive value of HRCT were compared with that of MRI,and the differences were not statistically significant(P >0.05).The positive predictive value and negative predictive value of HRCT and MRI examination were compared with the combined examination respectively,and the difference was not statistically significant(P>0.05).3.Diagnosed with congenital malformation through surgery or follow-up.The top three malformations were inner ear malformation,outer ear combined with middle ear malformation and outer ear malformation,accounting for 41.43%,20.00% and 15.71%,respectively.4.Among the 11 external ear malformations,the top three were stenosis of external auditory canal,locking of external auditory canal and membranous locking of external auditory canal,accounting for 36.36%,27.27% and 18.18% respectively.5.The first two of the seven middle ear malformations were stapes dysplasia and ossicular chain malformation,both of which were 42.86%.6.Among the 29 inner ear malformations,the top three were: enlarged vestibular aqueduct,cochlear malformation and internal auditory canal malformation,accounting for 51.72%,24.14% and 13.79%,respectively.7.Eight were level I,nine were level II,seven were level III and five were level IV.Grade I mainly focuses on middle ear malformation and inner ear malformation.Grade II mainly focuses on inner ear malformation;Grade III and IV mainly focus on inner ear malformation.8.Different types of ear malformations had different HRCT and MRI imaging features.ConclusionsThis study analyzed the accuracy,specificity,sensitivity,positive predictive value,negative predictive value and influence characteristics of HRCT and MRI in 58 children with congenital ear malformation.HRCT has a good resolution of bone and structure,and can clearly display the bone structure of the outer ear,middle ear and inner ear.But this method cannot show the membranous labyrinth,nerves and small peripheral blood vessels in the inner ear,some children with cochlear nerve dysplasia are easy to miss diagnosis.MRI can display the structure and shape of the labyrinthine membrane visually and stereoscopic in congenital ear malformations.It has a high display rate for the labyrinthine membrane,the combined detection of HRCT and MRI can significantly improve the diagnostic accuracy,specificity and sensitivity of congenital ear malformation.HRCT is dominant in the display of the osseous labyrinth structure of the external ear,middle ear and inner ear,while MRI is dominant in the situation of the internal auditory labyrinth and cochlear nerve,etc.The two are complementary,thus improving the diagnostic accuracy.