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Research ArticleHead and Neck Imaging

Measurement for Detection of Incomplete Partition Type II Anomalies on MR Imaging

K.L. Reinshagen, H.D. Curtin, A.M. Quesnel and A.F. Juliano
American Journal of Neuroradiology October 2017, 38 (10) 2003-2007; DOI: https://doi.org/10.3174/ajnr.A5335
K.L. Reinshagen
aFrom the Departments of Radiology (K.L.R., H.D.C., A.F.J.)
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H.D. Curtin
aFrom the Departments of Radiology (K.L.R., H.D.C., A.F.J.)
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A.M. Quesnel
bOtolaryngology (A.M.Q.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
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A.F. Juliano
aFrom the Departments of Radiology (K.L.R., H.D.C., A.F.J.)
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Abstract

BACKGROUND AND PURPOSE: Incomplete partition type II of the cochlea, commonly coexisting with an enlarged vestibular aqueduct, can be a challenging diagnosis on MR imaging due to the presence of a dysplastic spiral lamina–basilar membrane neural complex, which can resemble the normal interscalar septum. The purpose of this study was to determine a reproducible, quantitative cochlear measurement to assess incomplete partition type II anomalies in patients with enlarged vestibular aqueducts using normal-hearing ears as a control population.

MATERIALS AND METHODS: Retrospective analysis of 27 patients with enlarged vestibular aqueducts (54 ears) and 28 patients (33 ears) with normal audiographic findings who underwent MR imaging was performed. Using reformatted images from a cisternographic 3D MR imaging produced in a plane parallel to the lateral semicircular canal, we measured the distance (distance X) between the osseous spiral lamina-basilar membrane complex of the upper basal turn and the first linear signal void anterior to the basilar membrane.

RESULTS: The means of distance X in patients with normal hearing and prospectively diagnosed incomplete partition type II were, respectively, 0.93 ± 0.075 mm (range, 0.8–1.1 mm) and 1.55 ± 0.25 mm (range, 1–2.1 mm; P < .001). Using 3 SDs above the mean of patients with normal hearing (1.2 mm) as a cutoff for normal, we diagnosed 21/27 patients as having abnormal cochleas; 4/21 were diagnosed retrospectively. This finding indicated that almost 20% of patients were underdiagnosed. Interobserver agreement with 1.2 mm as a cutoff between normal and abnormal produced a κ score of 0.715 (good).

CONCLUSIONS: Incomplete partition type II anomalies on MR imaging can be subtle. A reproducible distance X of ≥1.2 mm is considered abnormal and may help to prospectively diagnose incomplete partition type II anomalies.

ABBREVIATIONS:

DRIVE
driven equilibrium
EVA
enlarged vestibular aqueduct
IP-II
incomplete partition type II
  • © 2017 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 38 (10)
American Journal of Neuroradiology
Vol. 38, Issue 10
1 Oct 2017
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K.L. Reinshagen, H.D. Curtin, A.M. Quesnel, A.F. Juliano
Measurement for Detection of Incomplete Partition Type II Anomalies on MR Imaging
American Journal of Neuroradiology Oct 2017, 38 (10) 2003-2007; DOI: 10.3174/ajnr.A5335

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Measurement for Detection of Incomplete Partition Type II Anomalies on MR Imaging
K.L. Reinshagen, H.D. Curtin, A.M. Quesnel, A.F. Juliano
American Journal of Neuroradiology Oct 2017, 38 (10) 2003-2007; DOI: 10.3174/ajnr.A5335
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