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Three-dimensional Imaging of the Inner Ear by Volume-Rendered Reconstructions of Magnetic Resonance Data
Randolf Klingebiel, MD;
Nadine Thieme, MD;
Dietmar Kivelitz, MD;
Christian Enzweiler, MD;
Mechthild Werbs, MD;
Rüdiger Lehmann, MD
Arch Otolaryngol Head Neck Surg. 2002;128:549-553.
Objective To evaluate 3-dimensional inner ear visualization by volume rendering
of high-resolution magnetic resonance data in patients with clinically suspected
inner ear abnormality.
Design Prospective comparative study of different postprocessing techniques,
based on blinded film readings.
Setting Tertiary referral hospital.
Subjects Fifty patients (17 females and 33 males) aged 1 to 77 years (average
age, 42 years) with sensorineural hearing loss, vertigo, and/or tinnitus.
Intervention Postprocessing of magnetic resonance data to inner ear reconstructions
by the use of volume rendering as well as maximum-intensity projection; caloric
testing by electronystagmography.
Main Outcome Measures Film was read blindly by 4 radiologists using a 5-point parameter scale
for image quality and diagnostic value. The assessibility of inner ear subsegments
was evaluated. The specificity of volume-rendered reconstructions for detecting
semicircular canal obliterations was assessed in a subgroup of 9 patients
by caloric testing. The time required for data postprocessing as well as film
reading was recorded by means of a stopwatch.
Results Volume-rendered inner ear reconstructions were superior in image quality
(P<.001), diagnostic value (P<.001), subsegment inner ear assessment (P<.01
to P<.001), and film reading time (P<.001) compared with maximum-intensity projections. The data postprocessing
time was comparable for both techniques. Caloric weakness was noted in all
patients assessed by electronystagmography.
Conclusion Volume rendering is the postprocessing technique of choice for 3-dimensional
inner ear visualization, performing better than maximum-intensity projections
with respect to various parameters.
From the Neuroradiology Section (Drs Klingebiel, Thieme, and Lehmann),
Department of Radiology (Dr Kivelitz), and Ear, Nose, and Throat Department
(Dr Werbs), Charité Campus Mitte, Humboldt University, Berlin, Germany;
and the Department of Radiology, Massachusetts General Hospital, Harvard Medical
School, Boston (Dr Enzweiler).
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