title: Clinical predictors of abnormal magnetic resonance imaging findings in patients with asymmetric sensorineural hearing loss.
abstract: OBJECTIVE
  Asymmetric sensorineural hearing loss (ASNHL) is commonly encountered in an otolaryngologic clinical practice. Determining what factors are associated with abnormal magnetic resonance imaging (MRI) findings will help with diagnostic workup.
  
  
  OBJECTIVE
  To evaluate the association between clinical and audiometric factors and abnormal MRI findings in patients with ASNHL.
  
  
  METHODS
  Retrospective medical record review from an urban, tertiary referral center of 451 patients with ASNHL who underwent MRI testing between January 2005 and December 2011.
  
  
  METHODS
  Medical records were reviewed for audiometric parameters as well as clinical presentation and compared with MRI results, which were categorized as abnormal, normal, or incidental. Data analysis included χ2 tests, logistic regression analysis, and multivariate analysis.
  
  
  RESULTS
  A total of 48 patients (10.6%) had abnormal MRI findings. Only 21 patients (4.7%) had a mass of the cerebellopontine angle/internal auditory canal on MRI, making up 40% of all abnormal MRI findings. The next most common MRI finding was labyrinthitis (n = 13; 25%). Vertigo/dizziness (n = 20; P = .01), tinnitus (n = 18; P = .02), sudden hearing loss (n = 15; P = .054), and 15-dB asymmetry at 3 kHz (n = 39; P = .01) were associated with abnormal MRI findings. Loud noise exposure was associated with normal MRI findings. Logistic regression analysis showed that vertigo/dizziness (odds ratio [OR], 2.14; 95% CI, 1.15-3.96; P = .02), unilateral tinnitus (OR, 2.15; 95% CI, 1.14-4.03; P = .02), and 15-dB asymmetry at 3 kHz (OR, 2.62; 95% CI, 1.24-5.57; P = .01) were significantly associated with abnormal MRI findings. Multivariate analysis showed that only 15-dB asymmetry at 3 kHz (OR, 2.42; 95% CI, 1.07-5.50; P = .03) was significantly associated with an abnormal MRI finding.
  
  
  CONCLUSIONS
  This study found that asymmetry of 15 dB at 3 kHz on audiometry was associated with higher positive yield on use of MRI in evaluating patients with ASNHL. We recommend that patients who present with ASNHL with this audiometric characteristic undergo MRI as part of their diagnostic workup.
authors.affiliation: Department of Otolaryngology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Syed F
authors.initials: SF
authors.lastname: Ahsan
authors.affiliation: Department of Otolaryngology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Robert
authors.initials: R
authors.lastname: Standring
authors.affiliation: Department of Diagnostic Radiology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Osborn
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan.
authors.forename: Ed
authors.initials: E
authors.lastname: Peterson
authors.affiliation: Department of Otolaryngology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Michael
authors.initials: M
authors.lastname: Seidman
authors.affiliation: Department of Radiology, New York University School of Medicine, New York.
authors.forename: Rajan
authors.initials: R
authors.lastname: Jain
mesh_terms: D001299:Audiometry; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA