Objective:

The aim of our study is to evaluate the diagnostic effectiveness of magnetic resonance imaging (MRI) compared to computed tomography (CT) in the detection of enlarged vestibular aqueduct (EVA) in childhood.

Methods:

One hundred twenty-three children who underwent temporal bone CT and MRI examinations for hearing loss between 2013 and 2020 were evaluated retrospectively. All CT and MRI images were examined by two pediatric radiologists, according to the Valvassori and Cincinnati criteria for EVA. Imaging findings on CT and MRI of the vestibular aqueduct were recorded. Two pediatric radiologists performed the measurements for EVA on CT and MRI. In addition, an otolaryngologist performed the measurements independently. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI compared to CT were calculated to detect EVA. The difference between the measurements on CT and MRI was investigated. The inter-observer agreement was evaluated for measurements.

Results:

The mean age of 123 children (65 boys and 58 girls) was 50.18±50.40 months. Two hundred forty-six ears were evaluated in 123 children. On CT images, EVA was present in 28 (11.3%) of 246 ears according to Cincinnati criteria and 27 (10.9%) of 246 ears according to Valvassori criteria, respectively. While sensitivity, specificity, PPD, and NPD rates of MRI were 100%, 99%, 92.8%, and 100%, respectively, for Cincinnati criteria, for Valvassori criteria, they were 100%, 97.3%, 77.7%, and 100%, respectively. According to the visual evaluation performed without using measurement, the enlarged appearance of the vestibular aqueduct was significant for the diagnosis of EVA (p<0.001), while the absence of this appearance was significant for the exclusion of EVA (p<0.001). There was no significant difference between the measurements on CT and MRI. There was a perfect correlation between the observers for measurements.

Conclusion:

MRI can be used as an initial imaging technique in children with suspicion of EVA to reduce radiation exposure.

Keywords: Magnetic resonance imaging, computed tomography, vestibular aqueduct, inner ear, diagnostic imaging, pediatric radiology