High-resolution CT is the mainstay for diagnosing an enlarged vestibular aqueduct (EVA), but MR imaging may be an appealing alternative, given its lack of ionizing radiation exposure. The purpose of this study was to determine how reliably MR imaging demonstrates the endolymphatic duct and endolymphatic duct enlargement in hearing-impaired children.

We performed a retrospective review of temporal bone high-resolution CT and MR imaging of hearing-impaired children evaluated between 2017 and 2020. Vestibular aqueduct diameter was measured on high-resolution CT. The vestibular aqueducts were categorized as being enlarged (EVA+) or nonenlarged (EVA–) using the Cincinnati criteria. The endolymphatic ducts were assessed on axial high-resolution CISS MR imaging. We categorized endolymphatic duct visibility into the following: type 1 (not visible), type 2 (faintly visible), and type 3 (easily visible). Mixed-effect logistic regression was used to identify associations between endolymphatic duct visibility and EVA. Interreader agreement for the endolymphatic duct among 3 independent readers was assessed using the Fleiss statistic.

In 196 ears from 98 children, endolymphatic duct visibility on MR imaging was type 1 in 74.0%, type 2 in 14.8%, and type 3 in 11.2%; 20.4% of ears were EVA+ on high-resolution CT. There was a significant association between EVA+ status and endolymphatic duct visibility (P < .01). Endolymphatic duct visibility was type 1 in 87.1%, type 2 in 12.8%, and type 3 in 0% of EVA– ears and type 1 in 22.5%, type 2 in 22.5%, and type 3 in 55.0% of EVA+ ears. The predicted probability of a type 3 endolymphatic duct being EVA+ was 0.997. There was almost perfect agreement among the 3 readers for distinguishing type 3 from type 1 or 2 endolymphatic ducts.

CISS MR imaging substantially underdiagnoses EVA; however, when a type 3 endolymphatic duct is evident, there is a >99% likelihood of an EVA.

高分辨率 CT 是诊断前庭导水管扩大 (EVA) 的主要手段，但由于缺乏电离辐射暴露，磁共振成像可能是一种有吸引力的替代方案。本研究的目的是确定 MR 成像显示听力受损儿童的内淋巴管和内淋巴管扩大的可靠性。

我们对 2017 年至 2020 年间评估的听力障碍儿童的颞骨高分辨率 CT 和 MR 成像进行了回顾性回顾。在高分辨率 CT 上测量了前庭导水管直径。使用辛辛那提标准将前庭导水管分为扩大（EVA+）或非扩大（EVA-）。通过轴向高分辨率 CISS MR 成像评估内淋巴管。我们将内淋巴管可见性分为以下几类：1 型（不可见）、2 型（微弱可见）和 3 型（容易可见）。混合效应逻辑回归用于确定内淋巴管可见度与 EVA 之间的关联。使用 Fleiss 统计数据评估了 3 位独立读者之间内淋巴管的读者间一致性。

在 98 名儿童的 196 只耳朵中，MR 成像上的内淋巴管可见度为 1 型（74.0%）、2 型（14.8%）和 3 型（11.2%）；高分辨率 CT 显示 20.4% 的耳朵为 EVA+。 EVA+ 状态与内淋巴管可见度之间存在显着相关性 ( P < .01)。内淋巴管可见度为 1 型（87.1%）、2 型（12.8%）、3 型（0%）的 EVA- 耳，1 型（22.5%）、2 型（22.5%）、3 型（55.0%）的 EVA+ 耳。 3 型内淋巴管为 EVA+ 的预测概率为 0.997。 3 位读者在区分 3 型内淋巴管与 1 型或 2 型内淋巴管方面几乎达成了完全一致。

CISS MR 成像严重低估了 EVA；然而，当 3 型内淋巴管明显时，EVA 的可能性>99%。