The role of virtual multi-detector computed tomography in diagnosing peripheral vertigo

Abstract

Abstract Background Multi-detector computed tomography (MDCT) has permitted the recognition and characterization of inner ear anomalies not previously identified, resulting in an optimal technique for the investigation of middle and inner ear pathologies with evaluation of anatomical variations in preoperative assessment. This study aimed to evaluate the role of virtual multi-detector computed tomography (MDCT) in diagnosing inner ear and labyrinthine system pathologies as potential causes of peripheral vertigo. Methods This prospective study was conducted on patients (aged 25–65 years) who were complaining of vertigo and clinically diagnosed after exclusion of central causes with computed tomography and magnetic resonance imaging (MRI) and vertigo with or without hearing loss. The rotatory chair and multi-slice computed tomography (MSCT) techniques were performed on all patients. Results In 30 patients, inner ear structure was evaluated by both virtual endoscopy (VE) and MDCT and the measurements were comparable by both techniques. After performing both VE and MDCT, virtual MDCT demonstrated superior sensitivity in detecting anatomical abnormalities such as semicircular canal (SCC) protrusions compared to virtual endoscopy (VE). Protrusions in semicircular canal (SCC) were detected in 2 cases and were detected in vestibule in 4 cases. Inner ear diameters measured by VE, median (IQR) were 1.85 (1.7–2.2), while MDCT values were 2.05 (1.9–2.3) The only finding that was detectable in two cases by both VE and MDCT was vestibular dilatation with a median (IQR) of 3.7 (3.65–3.75) vs 3.85 (3.82–3.87) mm, respectively, as the measurements were comparable by both techniques. Conclusions Virtual MDCT appears to detect inner ear pathologies; nevertheless, it is crucial for evaluating the anatomical details and could be a valuable imaging tool. Our initial result shows good anatomical delineation in Virtual MDCT, but further multicentric studies with large numbers of patients are required to support its superiority to other radiologic modalities. An advantage of virtual MDCT is its ability to clearly visualize anatomical details while excluding the artifacts.