False-positive magnetic resonance imaging of small internal auditory canal tumors: A clinical, radiologic, and pathologic correlation study

Background: The 2010 American Academy of Orthopaedic Surgeons Clinical Practice Guidelines report insufficient evidence to address the diagnostic efficacy of magnetic resonance imaging (MRI) for periprosthetic joint infection (PJI). Questions/Purposes: The purpose of this study was to determine the utility of MRI with multiacquisition variable-resonance image combination (MAVRIC) metal artifact suppression techniques in diagnosing PJI in the setting of total hip arthroplasty (THA). Methods: Multiacquisition variable-resonance image combination MRIs obtained of THAs between November 2012 and November 2016 were queried. Radiology reports were classified as positive (suspicious for infection), negative (no features of infection), or inconclusive (infection cannot be excluded or correlation with aspiration suggested if clinically concerned). Chart review identified cases of deep PJI according to the modified Musculoskeletal Infection Society criteria. Results: Of 2156 MRIs of THAs included, MRI was concerning for infection in 1.8% (n = 39), inconclusive in 1.2% (n = 26), and negative in 97.0% (n = 2091). Deep PJI was identified in 53 (2.5%) patients, 30 of whom (56.6%) had conclusively positive finding on MRI (false-negative rate: 43.4%, sensitivity: 56.6%). Of 2103 aseptic THAs, only 9 (0.4%) MRIs were read as suspicious for infection (false-positive rate: 0.4%; specificity: 99.6%). Conclusion: Magnetic resonance imaging with MAVRIC is a highly specific test for PJI with a low false-positive rate. This indicates that when clinicians are provided with an MRI that unexpectedly suggests infection, a formal evaluation for infection is indicated. In patients with otherwise equivocal diagnostic findings, MRI may help confirm, but not refute, a diagnosis of PJI. Prospective study with more experienced image reviewers may further support the use of MRI in PJI.

Download Full-text

Bony cochlear nerve canal and internal auditory canal measures predict cochlear nerve status

The Journal of Laryngology & Otology ◽

10.1017/s0022215117001141 ◽

2017 ◽

Vol 131 (8) ◽

pp. 676-683 ◽

Cited By ~ 11

Author(s):

E Tahir ◽

M D Bajin ◽

G Atay ◽

B Ö Mocan ◽

L Sennaroğlu

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Temporal Bone ◽

Internal Auditory Canal ◽

Cochlear Nerve ◽

Resonance Imaging ◽

Canal Stenosis ◽

Canal Diameter ◽

Canal Atresia

AbstractObjectives:The bony cochlear nerve canal is the space between the fundus of the internal auditory canal and the base of the cochlear modiolus that carries cochlear nerve fibres. This study aimed to determine the distribution of bony labyrinth anomalies and cochlear nerve anomalies in patients with bony cochlear nerve canal and internal auditory canal atresia and stenosis, and then to compare the diameter of the bony cochlear nerve canal and internal auditory canal with cochlear nerve status.Methods:The study included 38 sensorineural hearing loss patients (59 ears) in whom the bony cochlear nerve canal diameter at the mid-modiolus was 1.5 mm or less. Atretic and stenotic bony cochlear nerve canals were examined separately, and internal auditory canals with a mid-point diameter of less than 2 mm were considered stenotic. Temporal bone computed tomography and magnetic resonance imaging scans were reviewed to determine cochlear nerve status.Results:Cochlear hypoplasia was noted in 44 out of 59 ears (75 per cent) with a bony cochlear nerve canal diameter at the mid-modiolus of 1.5 mm or less. Approximately 33 per cent of ears with bony cochlear nerve canal stenosis also had a stenotic internal auditory canal and 84 per cent had a hypoplastic or aplastic cochlear nerve. All patients with bony cochlear nerve canal atresia had cochlear nerve deficiency. The cochlear nerve was hypoplastic or aplastic when the diameter of the bony cochlear nerve canal was less than 1.5 mm and the diameter of the internal auditory canal was less than 2 mm.Conclusion:The cochlear nerve may be aplastic or hypoplastic even if temporal bone computed tomography findings indicate a normal cochlea. If possible, patients scheduled to receive a cochlear implant should undergo both computed tomography and magnetic resonance imaging of the temporal bone. The bony cochlear nerve canal and internal auditory canal are complementary structures, and both should be assessed to determine cochlear nerve status.

Download Full-text

Evaluation of the facial nerve and internal auditory canal cross-sectional areas on three-dimensional fast imaging employing steady-state acquisition magnetic resonance imaging in Bell’s palsy

TURKISH JOURNAL OF MEDICAL SCIENCES ◽

10.3906/sag-1801-21 ◽

2018 ◽

Vol 48 (3) ◽

Keyword(s):

Magnetic Resonance Imaging ◽

Steady State ◽

Magnetic Resonance ◽

Facial Nerve ◽

Three Dimensional ◽

Internal Auditory Canal ◽

Bell’S Palsy ◽

Fast Imaging ◽

Resonance Imaging ◽

Cross Sectional

Download Full-text

Restricting False-positive Magnetic Resonance Imaging Scans to Reduce Overdiagnosis of Prostate Cancer

European Urology ◽

10.1016/j.eururo.2020.10.013 ◽

2021 ◽

Vol 79 (1) ◽

pp. 30-32

Author(s):

Chris H. Bangma ◽

Geert J.L.H. van Leenders ◽

Monique J. Roobol ◽

Ivo G. Schoots

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

False Positive ◽

Resonance Imaging

Download Full-text

Hypertrophic Pachymeningitis of the Internal Auditory Canal Induced by a Labyrinthine Fistula Complicated With Cholesteatoma

Ear Nose & Throat Journal ◽

10.1177/0145561320972612 ◽

2020 ◽

pp. 014556132097261

Author(s):

Kyeong Suk Park ◽

Bong-Jin Shin ◽

Chul Ho Jang

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Antibiotic Treatment ◽

Dura Mater ◽

Internal Auditory Canal ◽

Resonance Imaging ◽

Hypertrophic Pachymeningitis ◽

Labyrinthine Fistula ◽

First Case ◽

Mri Image

Hypertrophic pachymeningitis (HP) is defined by inflammation and thickening of the dura mater, and the etiologic factors are idiopathic or secondary to various conditions. To date, HP in the internal auditory canal (IAC) has rarely been reported. There have only been 3 reports of HP in the IAC. Magnetic resonance imaging showed enhancement of along the IAC and vestibule. After antibiotic treatment, enhancement was reduced with visible seventh and eighth nerves. The patient underwent tympanomastoidectomy. To our knowledge, this is the first case of HP associated with a labyrinth fistula complicated by cholesteatoma. We report MRI image with literatures.

Download Full-text