The Value Of Diffusion Spectrum Imaging In Diagnosis Of The Central Auditory Pathway Abnormalities In Patients With Idiopathic Sudden Sensorineural Hearing Loss

Objective:Previous studies have reported the auditory conduction pathway abnormalities in patients with sensorineural hearing loss(SNHL).This study aimed to further explore the auditory conduction pathway abnormalities in idilpathic sudden sensorineural hearing loss(ISSNHL)patients through generalized through diffusion spectrum imaging(DSI).Methods:In this institutional review board–approved prospective study,26 patients with ISSNHL(male 12,female 14,age 23~58 years,average 44.5±12.1 years)were enrolled as the experimental group and 23 matched healthy volunteers(males 11,female 12,aged 25-55 years,average 41±12.2 years)were enrolled as the control group.The symptoms that patients with ISSNHL are unilateral hearing loss.These participants were performed MRI scans at 3.0T(MAGNETOM Prisma,Siemens,Erlangen,Germany)with a 64 channels head coil within two weeks after visiting outpatient firstly.The protocols included the DSI、T1-Mprage and 3D-FIASTA sequence in order to exclude inner ear malformation and other inner ear lesions.DSI data were reconstructed with GQI model and the fiber tracts were analysed using DSI studio software.The ROI of auditory conduction pathway included the following region: corticospinal tract(CST),Heschl(HL),superior temporal gyrus(TS),middle temporal gyrus(TM),inferior temporal gyrus(TI),lateral lemniscus(LL),inferior colliculus(IC),41 and 42 in Brodman,anterior limb of internal capsule,posterior limb of the internal capsule,anterior corona,posterior corona.DSI metrics between hearing loss side and healthy-sided nerves in patients,and the hearing loss side with healthy-side nerves in normal-hearing controls were compared using the pared t test.Then the diagnostic performance of QA、GFA、ISO values were analyzed using the ROC method.A p value below 0.05 was considered significant difference.Results: No significant differences of QA、GFA、ISO values were found between the hearing loss side and the healthy-side in patients with SNHL(P>0.05).Comparison to the healthy controls,the increase of QA and ISO values in the patients tracts were observed,and significant difference was observed for the regions of anterior limb of internal capsule,anterior corona and posterior corona(P<0.05)in QA value,but in GFA、ISO values were no significant difference.ROC curve analysis demonstrated the sensitivity,specificity of anterior corona and posterior corona were 79.2% and 68.0%,60.0% and 65.0%,the AUC were 0.677 and 0.674(P<005).Conclusions: DSI seems can provide some valuable information in assessing the auditory conduction pathway abnormalities in ISSNHL,especially in anterior corona and posterior corona region.In the future,DSI may be used as a noninvasive method in clinical diagnosis and evaluation the treatment effect of ISSNHL.