Diagnostic yield of MRI for pediatric hearing loss: a systematic review.
OBJECTIVE
To perform a systematic review to analyze the diagnostic yield of magnetic resonance imaging (MRI) for pediatric hearing loss, including comparison to computed tomography (CT) and subgroup evaluation according to impairment severity and specific diagnostic findings (cochlear anomalies, enlarged vestibular aqueduct, cochlear nerve abnormalities, and brain findings).


METHODS
Pubmed, EMBASE, and the Cochrane library were assessed from their inception through December 2013. Manual searches were also performed, and topic experts were contacted.


METHODS
Data from studies describing the use of MRI with or without comparison to CT in the diagnostic evaluation of pediatric patients with hearing loss were evaluated, according to a priori inclusion/exclusion criteria. Two independent evaluators corroborated the extracted data. Heterogeneity was evaluated according to the I(2) statistic.


RESULTS
There were 29 studies that evaluated 2434 patients with MRIs and 1451 patients with CTs that met inclusion/exclusion criteria. There was a wide range of diagnostic yield from MRI. Heterogeneity among studies was substantial but improved with subgroup analysis. Meta-analysis of yield differences demonstrated that CT had a greater yield than MRI for enlarged vestibular aqueduct (yield difference 16.7% [95% CI, 9.1%-24.4%]) and a borderline advantage for cochlear anomalies (4.7% [95% CI, 0.1%-9.5%]). Studies were more likely to report brain findings with MRI.


CONCLUSIONS
These data may be utilized in concert with that from studies of risks of MRI and risk/yield of CT to inform the choice of diagnostic testing.
Harvard Medical School, Boston, Massachusetts, USA.
Bart
B
Kachniarz
Harvard Medical School, Boston, Massachusetts, USA.
Jenny X
JX
Chen
Harvard Medical School, Boston, Massachusetts, USA.
Sapideh
S
Gilani
Harvard Medical School, Boston, Massachusetts, USA jennifer_shin@meei.harvard.edu.
Jennifer J
JJ
Shin
D002648:Child; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging
adolescent; child; computed tomography; diagnostic yield; hearing loss; infant; magnetic resonance imaging; malignancy; pediatric; temporal bone anomaly