Pöschl Reformations Created from High-Resolution Noncontrast Enhanced CT Head Exams Can Be Used to Detect and Classify Superior Semicircular Canal Abnormalities.

OBJECTIVE

To compare the diagnostic capability of Pöschl reformations created from temporal bone CT (TBCT) and high-resolution noncontrast CT head exams (HR-NECTH) to detect and classify superior semicircular canal (SSC) abnormalities.

STUDY

DESIGN

Retrospective case review.

SETTING

Tertiary referral center.

PATIENTS: Individuals with normal and abnormal SSC who received TBCT and HR-NECTH.

INTERVENTIONS: Pöschl reformations of each patient's temporal bones (TB) were created using TBCT and HR-NECTH. Screenshots displaying the SSC were randomized into an interpretation test sent to neuroradiologists who interpreted the SSC as normal/abnormal and classified abnormalities as thinning (SST)/dehiscence (SSD).

MAIN OUTCOME MEASURE: Analysis of responses to interpretation test, interrater reliability, and sensitivity, specificity, and positive/negative predictive values of Pöschl reformations from TBCT and HR-NECTH.

RESULTS

Fourteen patients were enrolled, 28 TB were reviewed. Sixteen TB demonstrated SST/SDD and 12 were normal as per gold standard TBCT. Interpretation test displaying screenshots of the SSC, in a randomized, blinded fashion, was completed by four neuroradiologists. Analysis of TBCT and HR-NECTH Pöschl reformation interpretations yielded no statistically significant difference in proportion of true/false-positive/negative responses (χ2 = 3.37, p = 0.83), similar and substantial interrater reliability (k = 0.78 vs. 0.73, respectively), and similar sensitivity, specificity, and positive/negative predictive values (0.86, 1, 1, 0.84 vs. 0.78, 0.96, 0.96, 0.77, respectively). Neuroradiologists also correctly classified SST/SSD on TBCT and HR-NECTH Pöschl reformations at a rate of 70.9% vs. 78.0%, respectively.

CONCLUSION

Pöschl reformations created from HR-NECTH demonstrated similar diagnostic capability as those created from TBCT to detect and classify SSC abnormalities.