The usefulness of MR imaging of the temporal bone in the evaluation of patients with facial and audiovestibular dysfunction.
OBJECTIVE
To evaluate the clinical utility of MR imaging of the temporal bone in patients with facial and audiovestibular dysfunction with particular emphasis on the importance of contrast enhancement.


METHODS
We retrospectively reviewed the MR images of 179 patients [72 men, 107 women; average age, 44 (range, 1-77) years] who presented with peripheral facial palsy (n=15), audiometrically proven sensorineural hearing loss (n=104), vertigo (n=109), or tinnitus (n=92). Positive MR imaging findings possibly responsible for the patients' clinical manifestations were categorized according to the anatomic sites and presumed etiologies of the lesions. We also assessed the utility of contrast-enhanced MR imaging by analyzing its contribution to the demonstration of lesions which would otherwise not have been apparent. All MR images were interpreted by two neuroradiologists, who reached their conclusions by consensus.


RESULTS
MR images demonstrated positive findings, thought to account for the presenting symptoms, in 78 (44%) of 179 patients, including 15 (100%) of 15 with peripheral facial palsy, 43 (41%) of 104 with sensorineural hearing loss, 40 (37%) of 109 with vertigo, and 39 (42%) of 92 with tinnitus. Thirty (38%) of those 78 patients had lesions that could be confidently recognized only at contrast-enhanced MR imaging.


CONCLUSIONS
Even though its use led to positive findings in less than half of these patients, MR imaging of the temporal bone is a useful diagnostic procedure in the evaluation of those with facial and audiovestibular dysfunction. Because it was only at contrast-enhanced MR imaging that a significant number of patients showed positive imaging findings which explained their clinical manifestations, the use of contrast material is highly recommended.
Park
Sang Uk
SU
Department of Radiology, College of Medicine, Inha University Hospital, 7-206 3rd Street, Shinheung-dong, Joong-gu, Incheon 400-711, Korea.
Kim
Hyung Jin
HJ
Cho
Young Kuk
YK
Lim
Myung Kwan
MK
Kim
Won Hong
WH
Suh
Chang Hae
CH
Lee
Seung Chul
SC
D000328:Adult; D003287:Contrast Media; D005158:Facial Paralysis / Q000473:pathology*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013701:Temporal Bone / Q000473:pathology*; D014012:Tinnitus / Q000473:pathology*; D014717:Vertigo / Q000473:pathology*
D003287:Contrast Media