Can MRI predict olfactory loss and improvement in posttraumatic olfactory dysfunction?

IF 4.8 2区 医学 Q1 OTORHINOLARYNGOLOGY
Rhinology Pub Date : 2024-04-01 DOI:10.4193/Rhin23.246
J W Hsieh, V Lenoir, R Sipione, M Hugentobler, D Daskalou, J N Lundstrom, P Senn, J Rimmer, M Becker, B N Landis
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引用次数: 0

Abstract

Background: Although most patients with post-traumatic olfactory dysfunction (PTOD) undergo MRI, there is no consensus about its diagnostic or prognostic value. The aims were: 1) to classify the extent of post-traumatic neurodegeneration; 2) to determine its relationship with chemosensory dysfunction (smell, taste, trigeminal); and 3) to establish whether MRI can predict olfactory improvement.

Methodology: We conducted a retrospective cohort study based on a series of 56 patients with PTOD. All patients underwent validated psychophysical tests of their smell, taste, and trigeminal functions, otorhinolaryngologic evaluation, and MRI. An experienced radiologist blinded to patient data evaluated 40 chemosensory-relevant brain regions according to a four-point scale (0=no lesion to 3=large lesion). Follow up data after 4 years (on average) were available in 46 patients.

Results: The cluster analysis showed 4 brain lesion patterns that differed in lesion localization and severity. They are associated with diagnostic categories: anosmia, hyposmia and normosmia. Two clusters were highly specific for anosmia (100% specificity)and could accurately predict this condition (100% positive predictive value). No clusters were associated with trigeminal or taste dysfunction. Regarding improvement, 72.7% of patients in the cluster with mild lesions experienced subjective and measurable olfactory improvement whereas this was only the case in 21.7-37.5% of patients with larger lesions. The odds of subjective smell improvement were 5.9 times higher in patients within the milder cluster compared to larger ones.

Conclusions: The analysis of brain lesions in PTOD allows corroboration of smell test results and prediction of subjective and measurable improvement.

MRI能预测创伤后嗅觉功能障碍的丧失和改善吗?
背景:尽管大多数创伤后嗅觉功能障碍患者接受MRI检查,但其诊断或预后价值尚未达成共识。目的:1)对创伤后神经退行性变的程度进行分类;2)确定其与化学感觉功能障碍(嗅觉、味觉、三叉神经)的关系;3)确定MRI是否可以预测嗅觉改善。方法:我们进行了一项基于56例上睑下垂患者的回顾性队列研究。所有患者都进行了有效的心理物理测试,包括嗅觉、味觉和三叉神经功能、耳鼻喉科评估和MRI。一位经验丰富的放射科医生对患者数据不知情,根据4分制(0=无病变,3=大病变)评估了40个与化学感觉相关的大脑区域。46例患者平均4年随访数据。结果:聚类分析显示4种不同部位和严重程度的脑损伤类型。它们与诊断分类有关:嗅觉缺失、嗅觉减退和嗅觉正常。两个集群对嗅觉缺失有高度特异性(100%特异性),可以准确预测这种情况(100%阳性预测值)。没有群集与三叉神经或味觉功能障碍相关。在改善方面,72.7%的轻度病变患者的主观和可测量的嗅觉改善,而只有21.7-37.5%的较大病变患者有这种情况。与较大的患者相比,轻度患者的主观嗅觉改善的几率高出5.9倍。结论:对ptd脑病变的分析可以证实嗅觉测试结果,并预测主观和可测量的改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Rhinology
Rhinology 医学-耳鼻喉科学
CiteScore
15.80
自引率
9.70%
发文量
135
审稿时长
6-12 weeks
期刊介绍: Rhinology serves as the official Journal of the International Rhinologic Society and is recognized as one of the journals of the European Rhinologic Society. It offers a prominent platform for disseminating rhinologic research, reviews, position papers, task force reports, and guidelines to an international scientific audience. The journal also boasts the prestigious European Position Paper in Rhinosinusitis (EPOS), a highly influential publication first released in 2005 and subsequently updated in 2007, 2012, and most recently in 2020. Employing a double-blind peer review system, Rhinology welcomes original articles, review articles, and letters to the editor.
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