[The prognostic value of quantified MRI at an early stage of Bell's palsy].
OBJECTIVE
The aim of the study was to assess whether MRI has a prognostic value at an early stage of Bell's palsy.


METHODS
Prospective, blinded study on 30 patients suffering from Bell's palsy, who came to hospital until the sixth day of illness, to receive high doses steroid therapy. MRI was done on the first day of inpatient treatment as a gradient-echo-sequence with a slice thickness of 0.7 mm before and after i. v. administration of 0.1 mmol GdDTPA/kg weight. The signal intensity increase was evaluated quantitatively by region on interest (ROI). The results were compared to the clinical outcome and the results of electrophysiology.


RESULTS
The examinations of all patients could be evaluated. The 3 patients who developed a chronic facial paralysis were detected by MRI on the first day of inpatient treatment. The patients, who showed MR signs for an unfavorable course, had a highly significant pathologic compound muscle action potential (CMAP) as a result of the electrophysiologic measurement. Rather than using complex measurement procedures it is possible to obtain reliable prognostic information from just one measurement within the Internal auditory canal before and after i. v. administration of contrast.


CONCLUSIONS
MRI has a prognostic value at an early stage of the illness. In the clinical setting this measurement is easy to perform, so that it is possible to obtain prognostic information at a stage when causal treatment is still possible.
Kress
B P J
BP
Abteilung für Radiologie, Bundeswehrkrankenhaus, Ulm, Germany.
Griesbeck
F
F
Efinger
K
K
Gottschalk
A
A
Nissen
S
S
Goriup
A
A
Solbach
T
T
Kornhuber
A W
AW
Bähren
W
W
D000200:Action Potentials; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D020330:Bell Palsy / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011379:Prognosis; D011446:Prospective Studies; D013701:Temporal Bone; D013997:Time Factors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D003287:Contrast Media; D019786:Gadolinium DTPA